Arunava Biswas - Academia.edu (original) (raw)
Papers by Arunava Biswas
Asian Journal of Medical Sciences
Background: Etomidate is considered as an excellent drug for induction in anesthesia, although it... more Background: Etomidate is considered as an excellent drug for induction in anesthesia, although it has an undesirable side effect like myoclonus. Aims and Objectives: The aims of this study were to compare the effect between pre-treatment with nalbuphine and dexmedetomidine for attenuation and severity of etomidate induced myoclonus and to assess their adverse drug reaction. Materials and Methods: A prospective, randomized, and single-blinded study was conducted on patients undergoing elective surgery under general anesthesia. After selection of patients according to inclusion/exclusion criteria, nalbuphine (0.2 mg/kg) and dexmedetomidine (0.5 μg/kg) were infused 10 min before the induction of anesthesia. The vital parameters and any incidences of myoclonus during operation were observed at fixed interval. Results: A total of 102 patients in the age group of 18–60 years of either sex were assessed. In Group D 7, out of 51 patients (13.7%) were found to have myoclonus, whereas, in Gro...
PubMed, Nov 1, 2012
Learning environment in any medical college is found to be important in determining student's aca... more Learning environment in any medical college is found to be important in determining student's academic success. The study was undertaken to know and compare the perceptions of educational environment of undergraduate and postgraduate medical students, find out the problem areas and their remedies at Calcutta National Medical College and Hospital, Kolkata. In the present study, Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to undergraduate (n = 278) and postgraduate (n = 43) student and the scores were compared using a non-parametric test. Among the two groups, the undergraduate students were found to be more satisfied with the learning environment at Calcutta National Medical College and Hospital (as indicated by their higher DREEM score) compared to the postgraduate students. There was insignificant difference in perception among male and female students. The study revealed that both groups of students perceived the learning environment positively. Nevertheless, the study also reflected problematic areas of learning environment in this medical college which generates an idea of adopting some remedial measures in the form of small group learning and problem based learning where there is enough scope of student-teacher interaction and practical exposure.
PubMed, Mar 1, 2012
The study was conducted to evaluate the efficacy and safety of flupirtine maleate 100 mg thrice d... more The study was conducted to evaluate the efficacy and safety of flupirtine maleate 100 mg thrice daily compared to tramadol hydrochloride 50 mg thrice daily as postoperative pain management for 5 days. A total of 113 postoperative patients were recruited for the study. Those who met the inclusion criteria (n = 104) were randomised into two treatment groups. One of the groups received flupirtine maleate and the other tramadol hydrochloride both orally. The pain intensity was assessed by visual analogue scale. Patients were informed to report any adverse effect encountered during the study period. The overall effect of the drug (global assessment of the study medication) on pain and side-effects was assessed by the patients at the end of the trial on a categorical scale. There was significant reduction in pain score (p < 0.001) in the flupirtine group with almost equal efficacy to that of tramadol group but the incidence of adverse effects were much less (7.4%) and didn't need discontinuation of the study. All drugs were assessed as good. Therefore it can be concluded that oral flupirtine can deliver the same analgesic efficacy as oral tramadol for postoperative pain relief, which might be beneficial for avoiding the adverse effects ofopioids and non-steroidal anti-inflammatory drug therapy.
Journal of Clinical and Diagnostic Research, 2023
Introduction: Any major surgery like lower uterine Caesarean Section (CS) can be hazardous due to... more Introduction: Any major surgery like lower uterine Caesarean Section (CS) can be hazardous due to postoperative nosocomial infection. Pregnant mothers are at greater risk during such surgical intervention as compared to vaginal delivery. Prophylactic antibiotic administration is a standard practice across the globe to prevent such anticipated postoperative infection. Aim: To evaluate the prophylactic antimicrobial use with regards to the choice of antimicrobials, dose, route, timing and duration, any possible Adverse Drug Reaction (ADR) as well as to assess the frequency of the postoperative morbidity due to infection (if any).
Asian Journal of Medical Sciences, Oct 1, 2022
Background: Catheter-related bloodstream infection (CRBSI) is quite evident in hemodialysis (HD) ... more Background: Catheter-related bloodstream infection (CRBSI) is quite evident in hemodialysis (HD) patients. The pattern of the isolates from the catheter tip as well as blood culture and their sensitivity against antibiotics varies and set a huge challenge for the physician for its management. Aims and Objectives: The present study was undertaken to isolate and identify, causative organism in CRBSI from the HD patient and to determine the antibiotic susceptibility profile of each isolate and determines the current trend. Materials and Methods: A total (n=101) patients admitted for HD in the nephrology unit of a tertiary care hospital with preexisting comorbidities such as diabetes and hypertension (HT) were recruited according to inclusion/exclusion criteria after obtaining written consent. Blood samples from peripheral blood vessel of suspected CRBSI patients were collected as well as the catheter tip was cut and collected in sterile test tube and transported to microbiology laboratory for isolation, identification, and antibiotic susceptibility test. Results: The HD catheter tip culture was found positive in 54 (53.46%) samples out of the total 101 samples. The distribution of catheter tip culture positive patients and their association with diabetes mellitus was highest at age group > 60 years with a p < 0.0001. The association between catheter tip culture positive and HT was also found significant with P<0.0001. After analysis of culture reports of HD catheter tip and peripheral blood, culture-positive reports were found in 15 (14.85%) patients as CRBSI. The distribution of CRBSI predominantly found in the age group of 41-50 years (33%) which was significant with P=0.004. The causative organisms for CRBSI were Gram negative under this study and multidrug resistant too. The only drug polymyxin B was 100% sensitive to Gram-negative organism whereas vancomycin and linezolid were 100% sensitive to Gram-positive organisms. Conclusion: Patients with kidney disease receiving HD with a central venous catheter experience high rates of bloodstream and catheter tip infection commonly in those suffering from diabetes, HT, and dyslipidemia. The causative organisms for CRBSI were mainly Gram negative with a concern over existence of multidrug resistance strain.
Journal of Clinical and Diagnostic Research, 2020
Medical journal of Dr. D.Y. Patil Vidyapeeth, 2019
Context: Antibiotic resistance is a major threat to global health emerging rapidly in recent year... more Context: Antibiotic resistance is a major threat to global health emerging rapidly in recent years, especially in countries such as India. Aims: This study aims to study the knowledge, attitude, and practices of physicians toward this issue. Settings and Design: A cross-sectional study, over a period of 9 months, involving 100 medical officers working at primary and secondary tier hospitals in West Bengal. Subjects and Methods: A pretested, structured questionnaire with 15 items was used to collect information on knowledge, attitude, and practices. Statistical Analysis Used: Data were tabulated and analyzed. Results: About 61% had worked in infectious disease ward, 95% did not have any special training on rational antibiotic use. 84% had prescribed antibiotics more than 30 times in the past 3 months. Furthermore, 87%, 80%, and 67% reported confidence in prescribing correct type, correct dose, and correct duration of antibiotic, respectively. Previous knowledge/training and national policy/guidelines were prominent guiding factors for prescribing. 84% think antibiotic resistance is a national problem and 69% think that it exists in their hospitals. Patient push and fear of the treatment failure were the driving forces behind overprescription of antibiotics. More than half of the respondents think too many antibiotics prescribed, too long duration, too low dose, and use in livestock were the reason for the spread of antibiotic resistance. More than 50% think policy, training, monitoring, and regulation would help in combating antibiotic resistance. Conclusions: Identifying and addressing the driving forces behind the irrational use of antibiotics and bridging knowledge and attitude gap of clinicians would help combating antibiotic resistance. Appropriate policies, training, monitoring, and involving physicians as key stakeholders would be necessary for addressing the issue.
Asian Journal of Medical Sciences, Aug 31, 2018
Background: Neuropathy, being a common complication of diabetes mellitus is frequently encountere... more Background: Neuropathy, being a common complication of diabetes mellitus is frequently encountered in patients related to duration and severity of hyperglycaemia and had a multimodality treatment approach by the treating physicians. Aims and Objective: To understand and analyze the current drug prescribing trends in the management of diabetic neuropathy in hospitalized and OPD patients in a tertiary care hospital. Materials and Methods: A cross sectional, observational study on (n=100) patients of either sex aged between 18 to 70 years admitted in the Department of Neuromedicine as well as visiting the OPD was conducted for a period of 3 months. Prescriptions were collected and the relevant information i.e. drugs prescribed for diabetic neuropathy only excluding other drugs mentioned in the prescription were documented in a predesigned, pretested proforma and were analyzed. Results: All the prescribed drugs i.e. (100%) were oral formulations. The average number of drugs prescribed per prescription for the treatment of diabetic neuropathy including indoor and OPD patients was 3.60 ± 0.66. Prescription of single drug for the treatment of diabetic neuropathy was found to be the commonest trend among the prescribers i.e. 78% of all the prescriptions and they were all in their generic form. Conclusion: Gabapentin and pregablin (antiepileptics), amitryptylline (anti-depressants) and methylcobalamine were most commonly prescribed drugs. Side effects profiles of these drugs were also well evident among the patients. Much larger multicentric studies of similar type including private and public hospitals might reflect the true scenario of current drug prescribing trend among physicians in treating diabetic neuropathy.
Journal of Clinical and Diagnostic Research, 2017
Introduction: Pain during propofol injection is a very commonly and frequently encountered event ... more Introduction: Pain during propofol injection is a very commonly and frequently encountered event during induction of anaesthesia. A 5HT3 antagonists like granisetron are commonly used just prior to intravenous propofol as pre anaesthetic medication to prevent emesis in patients. Aim: Comparison of pre treatment with granisetron versus lignocaine with respect to amelioration of pain induced by injection of propofol, in patient admitted for elective surgery with general anaesthesia. Materials and Methods: A randomized double blinded controlled study was conducted with patients divided into three groups with (n=30) in each group. Group I (the placebo group) received 2 ml of 0.9% normal saline, Group II received 2 ml of 1% lignocaine and Group III received 2 ml of granisetron (1 mg/ml) as pre treatment medication respectively. The patient's complain regarding pain on intravenous propofol administration was recorded using the Verbal Rating Score. Pulse, BP, SpO 2 were noted meticulously on three occasions-immediately after pre-treatment, injecting full dose of propofol (not for pain assessment) and after 10 minutes. The results were analysed using the null hypothesis and two sample t-tests. Results: It was observed and obvious that the relief of pain was significant (p<0.05) when granisetron or lignocaine was compared with the placebo group. But there was insignificant difference (p>0.05) when granisetron was compared with lignocaine in terms of relieve of pain induced by propofol. Conclusion: It was concluded that parenteral administration of granisetron can be considered to be superior to lignocaine as pre treatment medication for pain relief after propofol injection along with the advantage of its anti-emetic effect.
Back ground: An intrauterine foetal demise or death (IUFD) is a major obstetrical catastrophe at ... more Back ground: An intrauterine foetal demise or death (IUFD) is a major obstetrical catastrophe at any gestational age. The objective of the present study is to determine the possible causes of stillbirths or intrauterine foetal demise after 28 weeks of gestation and to determine the preventive measures.Materials & Methods: A retrospective study was done in all pregnant women admitted with IUFD delivered at or above 28 weeks of gestation. Data analysis were done for maternal age, parity, antenatal visits, gestational age, probable causes of IUFD, pregnancy complications, placental abnormalities. Statistical data were analysed by using Microsoft Excel sheet.Results: Incidence of IUFD was 20.8 per 1000 total birth. It happened mostly (67.1%) in maternal age between >20 years and <30 years (p <0.001), illiterate (64.6%; p <0.001) and in middle class family (54.4%; p < 0.001). IUFD occurred with increasing gestational age (53.2% vs 46.8%; p = 0.045) and occurs mostly in rur...
International Journal of Health and Clinical Research, Feb 10, 2021
Introduction: COVID -19 infection may be a health threat for both mother and the growing child in... more Introduction: COVID -19 infection may be a health threat for both mother and the growing child in utero. Appropriate and authentic perception of information on COVID-19 is essential during pregnancy to avoid infection and stay safe and healthy in the changing global situation.Aim: The aim of the study was to understand the extent of knowledge and safe preventive practice followed against COVID -19 among non-infected pregnant women.Materials and Method:A cross sectional,observational, pre coded, pre validated questionnaire-based study was conducted on pregnant women in a tertiary care hospital attending OPD/IPD. Responses to questions were assessed by using a 5-point Likert scale and interpreted by percentage and chi square test. Result:All the mother were aware about the transmission and majority (72%)knew the clinical presentation of COVID-19. There was no significant correlation between age of participants and knowledge of COVID-19(p =0.538) but a strong correlation with educational level and correct knowledge was found (p<0.0001).Knowledge on some important aspects like breast feeding of baby, antenatal check-up or effect of lockdown/curfew on spread of infection during covid pandemic was lacking among the study participants. Conclusion: Most of the pregnant women responded correctly and had fair amount of knowledge on COVID-19 and practicing good preventive measures during their pregnancy. However, good educational programme to sensitize and proper health supervision from the healthcare authority might keep this special population safe and help in bridging the gap in their knowledge. Keywords: Knowledge, practice, covid-19, pregnancy, questionnaire, Likert scal
Journal of Clinical and Diagnostic Research, 2020
Introduction: Caesarean section is a common obstetric operation which requires adequate and safe ... more Introduction: Caesarean section is a common obstetric operation which requires adequate and safe postoperative analgesia sometimes using morphine or clonidine to provide comfort to the mother and ease in handling the new born. Aim: To compare the adjuvant effect of morphine and clonidine when co-administered intrathecally with 0.5% bupivacaine heavy during caesarean section. Materials and Methods: A randomised double-blinded study was conducted on 90 parturient were randomly divided into three groups, during March to November 2011, receiving intrathecal 100 mcg morphine, 75 mcg clonidine and 0.5 mL normal saline along with 2.5 mL of 0.5% bupivacaine respectively. The quality and duration of postoperative analgesia and any side effects were assessed at fixed time interval. APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score of foetus was also done to assess their wellbeing. Statistical analysis was done using Analysis of Variance (for continuous variables like Blood Pr...
Patients satisfaction is an important component of the healthcare delivery system. Patients satis... more Patients satisfaction is an important component of the healthcare delivery system. Patients satisfaction survey is an useful measure in gaining and understanding of the users’ needs and their perception of the services they receive. The study aimed towards assessing the levels of satisfaction upon Indoor Patients (n=200) in terms of five (5) underlying critical issues. A set of pre-structured and validated questionnaire was used as a tool to obtain the primary data. Multiple demographic factors were independent variables whereas five critical areas of satisfaction indices were the outcome variables. Subjects were interviewed by using twenty (20) item Likert Response Based Scale. Satisfaction indices were calculated by using standard criteria. Satisfaction Index (SI) of patients remained higher (P<0.0001) in private institutions while compared to that of government institutions. Factors like cost of healthcare, basic amenities, information and support systems and organization care...
Introduction: Osteoarthritis is a widespread health problem throughout the world, with 20%-30% of... more Introduction: Osteoarthritis is a widespread health problem throughout the world, with 20%-30% of patients aged over 65 years reported as symptomatic. This painful condition often unmanageable with conservative management. Objective: To compare the efficacy and safety of USG guided genicular nerve block and by anatomical landmark guided blind procedure in patients with OA knee.Materials & Methods: A parallel group open level randomized prospective study was conducted on patients suffering osteoarthritis of knee divided into ultrasound guided genicular nerve block (n=44) and anatomical landmark guided blind method (n=45) at a tertiary care hospital and followed up over a period of 12 weeks with assessment of pain, stiffness and function measured by visual analogue scale (VAS) and Western Ontorio and McMaster Universities Osteoarthritis (WOMAC) at regular interval.Results: A significant improvement in pain, stiffness and function (p<0.001) observed at 4and 12 weeks of interval in b...
ABSTRACT: Nicorandil is occasionally given for cardiovascular disorders in patients also sufferin... more ABSTRACT: Nicorandil is occasionally given for cardiovascular disorders in patients also suffering from diabetes mellitus. Simultaneous use of nicorandil and sulfonylureas may interfere with the euglycemia. The study was done to find the effect of nicorandil on glucose tolerance in normal male Wistar albino rats, under oral glucose load, adrenaline injection and in receiving oral hypoglycemic drugs. Male albino rats 100-120g was divided into control and treatment groups. The control group of rats received either oral 2 % gum acacia or normal saline subcutaneously. The treated groups received either glucose (1g/100g), glipizide (0.045mg/100g) or nicorandil (0.18mg/100g) orally alone or in combination. Blood samples were collected from lateral tail vein at 0, 1, 2 and 4hrs interval. Blood glucose estimation revealed that nicorandil significantly reduced glucose tolerance in normal rats and in rats made hyperglycemic by oral glucose load or adrenaline injection. It antagonized the hypo...
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021
Introduction: Successful airway management in patients with restricted cervical spine movement is... more Introduction: Successful airway management in patients with restricted cervical spine movement is always very challenging as there is no consensus regarding management of difficult airway in such patients with limited or no cervical spine mobility. Aim: To assess whether the King Vision® Video Laryngoscope (KVVL) provides a better view of the glottis and has higher success rate of tracheal intubation than McCoy laryngoscope in patients with simulated difficult airway. Materials and Methods: A prospective, longitudinal, comparative study was conducted with prior approval from Institutional Ethics Committee, 100 patients were divided equally (n=50) into group V {Video Laryngoscope (VL)} and group M (McCoy laryngoscope). Time required for laryngoscopy and intubation, any damage to teeth or soft tissue injury was noted and view of the glottis was graded using a modified classification reported by Cormack and Lehane. Qualitative data (sex, American Society of Anesthesiologists (ASA) phys...
Introduction The study was conducted to know the prevalence of various types of Idiopathic Childh... more Introduction The study was conducted to know the prevalence of various types of Idiopathic Childhood Epilepsy and the utilization pattern of Antiepileptic drugs (AED) in the tertiary referral center. Method A total of 100 Idiopathic epileptic patients of both sexes below 15yrs of age who were prescribed an AED (Antiepileptic drug) were considered for analysis. Demographic profile, type of epilepsy, AED, number of epileptic events, biochemical, EEG and ADR (Adverse drug reaction) data were collected and analyzed. Results Among all subjects 58% (Male56%)are children <5yrs. Incidence of Generalized Tonic-Clonic Seizure (GTCS) was 80%, Complex Partial Seizure 60%, Partial Seizure with Secondary Generalization 32%, Simple Partial Seizure 8%, Myoclonic 8%, Absence 7% and Atonic 5%. Valproate was the most commonly prescribed drug in GTCS, Atonic, Myoclonic and Absence seizure. Carbamazepine was commonly prescribed drug in Partial seizure. A total of 110 AEDs (i.e.1.1 AED per patient) we...
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2020
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018
Introduction: The geriatric population of the world is increasing, who very often suffers from mu... more Introduction: The geriatric population of the world is increasing, who very often suffers from multiple comorbidities and exposed to polypharmacy by multiple treating physicians.
Asian Journal of Medical Sciences, 2019
Background: Pretest-posttest questionnaire are often used during workshop to assess the impact of... more Background: Pretest-posttest questionnaire are often used during workshop to assess the impact of a program on the participants. However, the reliability of such data collection ‘tool’ is not often judged. There is lack of evidence supporting the authentication of such research instrument. Aims and Objective: This study was conducted to assess the reliability of prepost test questionnaire comprising MCQs, on participants attending a one-day workshop on clinical pharmacology at a teaching hospital in eastern India. Materials and Methods: Pre and post test questionnaire comprising 15 MCQs covering different aspects of ‘Good Clinical Practices’ on which several presentations were later delivered by experts were distributed to (n=42) participants in a one-day oriented workshop within stipulated time period and their feedback were collected and statistically analyzed after the workshop was over. Results: The average number of MCQs attempted in the pretest questionnaire was 12.42 and in p...
Asian Journal of Medical Sciences
Background: Etomidate is considered as an excellent drug for induction in anesthesia, although it... more Background: Etomidate is considered as an excellent drug for induction in anesthesia, although it has an undesirable side effect like myoclonus. Aims and Objectives: The aims of this study were to compare the effect between pre-treatment with nalbuphine and dexmedetomidine for attenuation and severity of etomidate induced myoclonus and to assess their adverse drug reaction. Materials and Methods: A prospective, randomized, and single-blinded study was conducted on patients undergoing elective surgery under general anesthesia. After selection of patients according to inclusion/exclusion criteria, nalbuphine (0.2 mg/kg) and dexmedetomidine (0.5 μg/kg) were infused 10 min before the induction of anesthesia. The vital parameters and any incidences of myoclonus during operation were observed at fixed interval. Results: A total of 102 patients in the age group of 18–60 years of either sex were assessed. In Group D 7, out of 51 patients (13.7%) were found to have myoclonus, whereas, in Gro...
PubMed, Nov 1, 2012
Learning environment in any medical college is found to be important in determining student's aca... more Learning environment in any medical college is found to be important in determining student's academic success. The study was undertaken to know and compare the perceptions of educational environment of undergraduate and postgraduate medical students, find out the problem areas and their remedies at Calcutta National Medical College and Hospital, Kolkata. In the present study, Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to undergraduate (n = 278) and postgraduate (n = 43) student and the scores were compared using a non-parametric test. Among the two groups, the undergraduate students were found to be more satisfied with the learning environment at Calcutta National Medical College and Hospital (as indicated by their higher DREEM score) compared to the postgraduate students. There was insignificant difference in perception among male and female students. The study revealed that both groups of students perceived the learning environment positively. Nevertheless, the study also reflected problematic areas of learning environment in this medical college which generates an idea of adopting some remedial measures in the form of small group learning and problem based learning where there is enough scope of student-teacher interaction and practical exposure.
PubMed, Mar 1, 2012
The study was conducted to evaluate the efficacy and safety of flupirtine maleate 100 mg thrice d... more The study was conducted to evaluate the efficacy and safety of flupirtine maleate 100 mg thrice daily compared to tramadol hydrochloride 50 mg thrice daily as postoperative pain management for 5 days. A total of 113 postoperative patients were recruited for the study. Those who met the inclusion criteria (n = 104) were randomised into two treatment groups. One of the groups received flupirtine maleate and the other tramadol hydrochloride both orally. The pain intensity was assessed by visual analogue scale. Patients were informed to report any adverse effect encountered during the study period. The overall effect of the drug (global assessment of the study medication) on pain and side-effects was assessed by the patients at the end of the trial on a categorical scale. There was significant reduction in pain score (p < 0.001) in the flupirtine group with almost equal efficacy to that of tramadol group but the incidence of adverse effects were much less (7.4%) and didn't need discontinuation of the study. All drugs were assessed as good. Therefore it can be concluded that oral flupirtine can deliver the same analgesic efficacy as oral tramadol for postoperative pain relief, which might be beneficial for avoiding the adverse effects ofopioids and non-steroidal anti-inflammatory drug therapy.
Journal of Clinical and Diagnostic Research, 2023
Introduction: Any major surgery like lower uterine Caesarean Section (CS) can be hazardous due to... more Introduction: Any major surgery like lower uterine Caesarean Section (CS) can be hazardous due to postoperative nosocomial infection. Pregnant mothers are at greater risk during such surgical intervention as compared to vaginal delivery. Prophylactic antibiotic administration is a standard practice across the globe to prevent such anticipated postoperative infection. Aim: To evaluate the prophylactic antimicrobial use with regards to the choice of antimicrobials, dose, route, timing and duration, any possible Adverse Drug Reaction (ADR) as well as to assess the frequency of the postoperative morbidity due to infection (if any).
Asian Journal of Medical Sciences, Oct 1, 2022
Background: Catheter-related bloodstream infection (CRBSI) is quite evident in hemodialysis (HD) ... more Background: Catheter-related bloodstream infection (CRBSI) is quite evident in hemodialysis (HD) patients. The pattern of the isolates from the catheter tip as well as blood culture and their sensitivity against antibiotics varies and set a huge challenge for the physician for its management. Aims and Objectives: The present study was undertaken to isolate and identify, causative organism in CRBSI from the HD patient and to determine the antibiotic susceptibility profile of each isolate and determines the current trend. Materials and Methods: A total (n=101) patients admitted for HD in the nephrology unit of a tertiary care hospital with preexisting comorbidities such as diabetes and hypertension (HT) were recruited according to inclusion/exclusion criteria after obtaining written consent. Blood samples from peripheral blood vessel of suspected CRBSI patients were collected as well as the catheter tip was cut and collected in sterile test tube and transported to microbiology laboratory for isolation, identification, and antibiotic susceptibility test. Results: The HD catheter tip culture was found positive in 54 (53.46%) samples out of the total 101 samples. The distribution of catheter tip culture positive patients and their association with diabetes mellitus was highest at age group > 60 years with a p < 0.0001. The association between catheter tip culture positive and HT was also found significant with P<0.0001. After analysis of culture reports of HD catheter tip and peripheral blood, culture-positive reports were found in 15 (14.85%) patients as CRBSI. The distribution of CRBSI predominantly found in the age group of 41-50 years (33%) which was significant with P=0.004. The causative organisms for CRBSI were Gram negative under this study and multidrug resistant too. The only drug polymyxin B was 100% sensitive to Gram-negative organism whereas vancomycin and linezolid were 100% sensitive to Gram-positive organisms. Conclusion: Patients with kidney disease receiving HD with a central venous catheter experience high rates of bloodstream and catheter tip infection commonly in those suffering from diabetes, HT, and dyslipidemia. The causative organisms for CRBSI were mainly Gram negative with a concern over existence of multidrug resistance strain.
Journal of Clinical and Diagnostic Research, 2020
Medical journal of Dr. D.Y. Patil Vidyapeeth, 2019
Context: Antibiotic resistance is a major threat to global health emerging rapidly in recent year... more Context: Antibiotic resistance is a major threat to global health emerging rapidly in recent years, especially in countries such as India. Aims: This study aims to study the knowledge, attitude, and practices of physicians toward this issue. Settings and Design: A cross-sectional study, over a period of 9 months, involving 100 medical officers working at primary and secondary tier hospitals in West Bengal. Subjects and Methods: A pretested, structured questionnaire with 15 items was used to collect information on knowledge, attitude, and practices. Statistical Analysis Used: Data were tabulated and analyzed. Results: About 61% had worked in infectious disease ward, 95% did not have any special training on rational antibiotic use. 84% had prescribed antibiotics more than 30 times in the past 3 months. Furthermore, 87%, 80%, and 67% reported confidence in prescribing correct type, correct dose, and correct duration of antibiotic, respectively. Previous knowledge/training and national policy/guidelines were prominent guiding factors for prescribing. 84% think antibiotic resistance is a national problem and 69% think that it exists in their hospitals. Patient push and fear of the treatment failure were the driving forces behind overprescription of antibiotics. More than half of the respondents think too many antibiotics prescribed, too long duration, too low dose, and use in livestock were the reason for the spread of antibiotic resistance. More than 50% think policy, training, monitoring, and regulation would help in combating antibiotic resistance. Conclusions: Identifying and addressing the driving forces behind the irrational use of antibiotics and bridging knowledge and attitude gap of clinicians would help combating antibiotic resistance. Appropriate policies, training, monitoring, and involving physicians as key stakeholders would be necessary for addressing the issue.
Asian Journal of Medical Sciences, Aug 31, 2018
Background: Neuropathy, being a common complication of diabetes mellitus is frequently encountere... more Background: Neuropathy, being a common complication of diabetes mellitus is frequently encountered in patients related to duration and severity of hyperglycaemia and had a multimodality treatment approach by the treating physicians. Aims and Objective: To understand and analyze the current drug prescribing trends in the management of diabetic neuropathy in hospitalized and OPD patients in a tertiary care hospital. Materials and Methods: A cross sectional, observational study on (n=100) patients of either sex aged between 18 to 70 years admitted in the Department of Neuromedicine as well as visiting the OPD was conducted for a period of 3 months. Prescriptions were collected and the relevant information i.e. drugs prescribed for diabetic neuropathy only excluding other drugs mentioned in the prescription were documented in a predesigned, pretested proforma and were analyzed. Results: All the prescribed drugs i.e. (100%) were oral formulations. The average number of drugs prescribed per prescription for the treatment of diabetic neuropathy including indoor and OPD patients was 3.60 ± 0.66. Prescription of single drug for the treatment of diabetic neuropathy was found to be the commonest trend among the prescribers i.e. 78% of all the prescriptions and they were all in their generic form. Conclusion: Gabapentin and pregablin (antiepileptics), amitryptylline (anti-depressants) and methylcobalamine were most commonly prescribed drugs. Side effects profiles of these drugs were also well evident among the patients. Much larger multicentric studies of similar type including private and public hospitals might reflect the true scenario of current drug prescribing trend among physicians in treating diabetic neuropathy.
Journal of Clinical and Diagnostic Research, 2017
Introduction: Pain during propofol injection is a very commonly and frequently encountered event ... more Introduction: Pain during propofol injection is a very commonly and frequently encountered event during induction of anaesthesia. A 5HT3 antagonists like granisetron are commonly used just prior to intravenous propofol as pre anaesthetic medication to prevent emesis in patients. Aim: Comparison of pre treatment with granisetron versus lignocaine with respect to amelioration of pain induced by injection of propofol, in patient admitted for elective surgery with general anaesthesia. Materials and Methods: A randomized double blinded controlled study was conducted with patients divided into three groups with (n=30) in each group. Group I (the placebo group) received 2 ml of 0.9% normal saline, Group II received 2 ml of 1% lignocaine and Group III received 2 ml of granisetron (1 mg/ml) as pre treatment medication respectively. The patient's complain regarding pain on intravenous propofol administration was recorded using the Verbal Rating Score. Pulse, BP, SpO 2 were noted meticulously on three occasions-immediately after pre-treatment, injecting full dose of propofol (not for pain assessment) and after 10 minutes. The results were analysed using the null hypothesis and two sample t-tests. Results: It was observed and obvious that the relief of pain was significant (p<0.05) when granisetron or lignocaine was compared with the placebo group. But there was insignificant difference (p>0.05) when granisetron was compared with lignocaine in terms of relieve of pain induced by propofol. Conclusion: It was concluded that parenteral administration of granisetron can be considered to be superior to lignocaine as pre treatment medication for pain relief after propofol injection along with the advantage of its anti-emetic effect.
Back ground: An intrauterine foetal demise or death (IUFD) is a major obstetrical catastrophe at ... more Back ground: An intrauterine foetal demise or death (IUFD) is a major obstetrical catastrophe at any gestational age. The objective of the present study is to determine the possible causes of stillbirths or intrauterine foetal demise after 28 weeks of gestation and to determine the preventive measures.Materials & Methods: A retrospective study was done in all pregnant women admitted with IUFD delivered at or above 28 weeks of gestation. Data analysis were done for maternal age, parity, antenatal visits, gestational age, probable causes of IUFD, pregnancy complications, placental abnormalities. Statistical data were analysed by using Microsoft Excel sheet.Results: Incidence of IUFD was 20.8 per 1000 total birth. It happened mostly (67.1%) in maternal age between >20 years and <30 years (p <0.001), illiterate (64.6%; p <0.001) and in middle class family (54.4%; p < 0.001). IUFD occurred with increasing gestational age (53.2% vs 46.8%; p = 0.045) and occurs mostly in rur...
International Journal of Health and Clinical Research, Feb 10, 2021
Introduction: COVID -19 infection may be a health threat for both mother and the growing child in... more Introduction: COVID -19 infection may be a health threat for both mother and the growing child in utero. Appropriate and authentic perception of information on COVID-19 is essential during pregnancy to avoid infection and stay safe and healthy in the changing global situation.Aim: The aim of the study was to understand the extent of knowledge and safe preventive practice followed against COVID -19 among non-infected pregnant women.Materials and Method:A cross sectional,observational, pre coded, pre validated questionnaire-based study was conducted on pregnant women in a tertiary care hospital attending OPD/IPD. Responses to questions were assessed by using a 5-point Likert scale and interpreted by percentage and chi square test. Result:All the mother were aware about the transmission and majority (72%)knew the clinical presentation of COVID-19. There was no significant correlation between age of participants and knowledge of COVID-19(p =0.538) but a strong correlation with educational level and correct knowledge was found (p<0.0001).Knowledge on some important aspects like breast feeding of baby, antenatal check-up or effect of lockdown/curfew on spread of infection during covid pandemic was lacking among the study participants. Conclusion: Most of the pregnant women responded correctly and had fair amount of knowledge on COVID-19 and practicing good preventive measures during their pregnancy. However, good educational programme to sensitize and proper health supervision from the healthcare authority might keep this special population safe and help in bridging the gap in their knowledge. Keywords: Knowledge, practice, covid-19, pregnancy, questionnaire, Likert scal
Journal of Clinical and Diagnostic Research, 2020
Introduction: Caesarean section is a common obstetric operation which requires adequate and safe ... more Introduction: Caesarean section is a common obstetric operation which requires adequate and safe postoperative analgesia sometimes using morphine or clonidine to provide comfort to the mother and ease in handling the new born. Aim: To compare the adjuvant effect of morphine and clonidine when co-administered intrathecally with 0.5% bupivacaine heavy during caesarean section. Materials and Methods: A randomised double-blinded study was conducted on 90 parturient were randomly divided into three groups, during March to November 2011, receiving intrathecal 100 mcg morphine, 75 mcg clonidine and 0.5 mL normal saline along with 2.5 mL of 0.5% bupivacaine respectively. The quality and duration of postoperative analgesia and any side effects were assessed at fixed time interval. APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score of foetus was also done to assess their wellbeing. Statistical analysis was done using Analysis of Variance (for continuous variables like Blood Pr...
Patients satisfaction is an important component of the healthcare delivery system. Patients satis... more Patients satisfaction is an important component of the healthcare delivery system. Patients satisfaction survey is an useful measure in gaining and understanding of the users’ needs and their perception of the services they receive. The study aimed towards assessing the levels of satisfaction upon Indoor Patients (n=200) in terms of five (5) underlying critical issues. A set of pre-structured and validated questionnaire was used as a tool to obtain the primary data. Multiple demographic factors were independent variables whereas five critical areas of satisfaction indices were the outcome variables. Subjects were interviewed by using twenty (20) item Likert Response Based Scale. Satisfaction indices were calculated by using standard criteria. Satisfaction Index (SI) of patients remained higher (P<0.0001) in private institutions while compared to that of government institutions. Factors like cost of healthcare, basic amenities, information and support systems and organization care...
Introduction: Osteoarthritis is a widespread health problem throughout the world, with 20%-30% of... more Introduction: Osteoarthritis is a widespread health problem throughout the world, with 20%-30% of patients aged over 65 years reported as symptomatic. This painful condition often unmanageable with conservative management. Objective: To compare the efficacy and safety of USG guided genicular nerve block and by anatomical landmark guided blind procedure in patients with OA knee.Materials & Methods: A parallel group open level randomized prospective study was conducted on patients suffering osteoarthritis of knee divided into ultrasound guided genicular nerve block (n=44) and anatomical landmark guided blind method (n=45) at a tertiary care hospital and followed up over a period of 12 weeks with assessment of pain, stiffness and function measured by visual analogue scale (VAS) and Western Ontorio and McMaster Universities Osteoarthritis (WOMAC) at regular interval.Results: A significant improvement in pain, stiffness and function (p<0.001) observed at 4and 12 weeks of interval in b...
ABSTRACT: Nicorandil is occasionally given for cardiovascular disorders in patients also sufferin... more ABSTRACT: Nicorandil is occasionally given for cardiovascular disorders in patients also suffering from diabetes mellitus. Simultaneous use of nicorandil and sulfonylureas may interfere with the euglycemia. The study was done to find the effect of nicorandil on glucose tolerance in normal male Wistar albino rats, under oral glucose load, adrenaline injection and in receiving oral hypoglycemic drugs. Male albino rats 100-120g was divided into control and treatment groups. The control group of rats received either oral 2 % gum acacia or normal saline subcutaneously. The treated groups received either glucose (1g/100g), glipizide (0.045mg/100g) or nicorandil (0.18mg/100g) orally alone or in combination. Blood samples were collected from lateral tail vein at 0, 1, 2 and 4hrs interval. Blood glucose estimation revealed that nicorandil significantly reduced glucose tolerance in normal rats and in rats made hyperglycemic by oral glucose load or adrenaline injection. It antagonized the hypo...
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021
Introduction: Successful airway management in patients with restricted cervical spine movement is... more Introduction: Successful airway management in patients with restricted cervical spine movement is always very challenging as there is no consensus regarding management of difficult airway in such patients with limited or no cervical spine mobility. Aim: To assess whether the King Vision® Video Laryngoscope (KVVL) provides a better view of the glottis and has higher success rate of tracheal intubation than McCoy laryngoscope in patients with simulated difficult airway. Materials and Methods: A prospective, longitudinal, comparative study was conducted with prior approval from Institutional Ethics Committee, 100 patients were divided equally (n=50) into group V {Video Laryngoscope (VL)} and group M (McCoy laryngoscope). Time required for laryngoscopy and intubation, any damage to teeth or soft tissue injury was noted and view of the glottis was graded using a modified classification reported by Cormack and Lehane. Qualitative data (sex, American Society of Anesthesiologists (ASA) phys...
Introduction The study was conducted to know the prevalence of various types of Idiopathic Childh... more Introduction The study was conducted to know the prevalence of various types of Idiopathic Childhood Epilepsy and the utilization pattern of Antiepileptic drugs (AED) in the tertiary referral center. Method A total of 100 Idiopathic epileptic patients of both sexes below 15yrs of age who were prescribed an AED (Antiepileptic drug) were considered for analysis. Demographic profile, type of epilepsy, AED, number of epileptic events, biochemical, EEG and ADR (Adverse drug reaction) data were collected and analyzed. Results Among all subjects 58% (Male56%)are children <5yrs. Incidence of Generalized Tonic-Clonic Seizure (GTCS) was 80%, Complex Partial Seizure 60%, Partial Seizure with Secondary Generalization 32%, Simple Partial Seizure 8%, Myoclonic 8%, Absence 7% and Atonic 5%. Valproate was the most commonly prescribed drug in GTCS, Atonic, Myoclonic and Absence seizure. Carbamazepine was commonly prescribed drug in Partial seizure. A total of 110 AEDs (i.e.1.1 AED per patient) we...
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2020
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018
Introduction: The geriatric population of the world is increasing, who very often suffers from mu... more Introduction: The geriatric population of the world is increasing, who very often suffers from multiple comorbidities and exposed to polypharmacy by multiple treating physicians.
Asian Journal of Medical Sciences, 2019
Background: Pretest-posttest questionnaire are often used during workshop to assess the impact of... more Background: Pretest-posttest questionnaire are often used during workshop to assess the impact of a program on the participants. However, the reliability of such data collection ‘tool’ is not often judged. There is lack of evidence supporting the authentication of such research instrument. Aims and Objective: This study was conducted to assess the reliability of prepost test questionnaire comprising MCQs, on participants attending a one-day workshop on clinical pharmacology at a teaching hospital in eastern India. Materials and Methods: Pre and post test questionnaire comprising 15 MCQs covering different aspects of ‘Good Clinical Practices’ on which several presentations were later delivered by experts were distributed to (n=42) participants in a one-day oriented workshop within stipulated time period and their feedback were collected and statistically analyzed after the workshop was over. Results: The average number of MCQs attempted in the pretest questionnaire was 12.42 and in p...