Kirtida Tandel - Academia.edu (original) (raw)

Papers by Kirtida Tandel

National Journal of Physiology, Pharmacy and Pharmacology, 2018

Increasing evidence has underlined the importance of oxidative stress in the Pathophysiology of h... more Increasing evidence has underlined the importance of oxidative stress in the Pathophysiology of hypertension and its contribution to the associated complications. However the correlation between oxidative stress parameters and blood pressure levels is not clearly understood. Thus present study was done to evaluate the oxidative stress parameters in patients with hypertension and to check the correlation, if any, between these parameters and systolic and diastolic blood pressure. Plasma malondialdehyde, superoxide dismutase and catalase levels were measured in sixty hypertensive and forty normotensive subjects. Pearson’s correlation analysis was performed to study the correlation between these parameters and systolic and diastolic blood pressure. Enhanced oxidative stress was observed in hypertensive subjects as denoted by raised plasma malondialdehyde levels and reduced superoxide dismutase and catalase levels. Plasma malondialdehyde correlated positively whereas superoxide dismutas...

National Journal of Physiology, Pharmacy and Pharmacology, 2019

Background: The increasing health-care expenses are a major concern for the health-care proving s... more Background: The increasing health-care expenses are a major concern for the health-care proving system in the world. As stated by the World Health Organization, in the majority of developing countries out of pocket expenses may go as high as 80% of total health-care expenditures. In developing countries like India, the generic medicines are not widely prescribed due to lack of knowledge and awareness regarding generic medicines in both prescribers and in patients. Understanding of prescriber’s attitude and perceptions regarding the quality, efficacy, and safety of generic medicines may help to identify important barriers for better generic prescribing. Aims and Objectives: The aim of the study was to assess the knowledge, attitude, and practice of generic medicines among intern doctors at a tertiary care teaching hospital. Materials and Methods: A prospective, cross-sectional study was conducted among intern doctors at a tertiary care teaching hospital using a questionnaire, consisting of questions related to knowledge, attitude, and practice regarding generic medicines. Data were analyzed by MS Excel. Results: A total of 105 (88%) interns responded to the questionnaire. Around 60% of interns agreed with that generic medicine can be used in place of innovator (patented) medicine. Among all the interns, 52.4% were aware of that generic medicine contains the same active ingredient as their counterpart innovator medicine. More than half of interns (55.2 %) were aware of Jan Aushadhi scheme launched by the Government of India. Around 69.5% of interns disagreed with that generic medicines cost less because they are inferior to innovator medicines. Majority of interns (88.6%) were of the opinion that there should be some training session to raise the knowledge and awareness about generic medicines. Around half of the interns (50.5%) had never switch a patient on innovator medicine to generic medicine. Only 1% was not in favor of supporting generic drug prescribing. Conclusion: Knowledge of intern doctors regarding concept and regulations about generic drugs is adequate. Although they prescribe a good number of generic drugs, concerns regarding quality, efficacy, safety, availability, and awareness are present among them. Hence, mass awareness programs and training sessions are required to address these concerns which may alter their prescribing behavior and can encourage for more use of generic medicines.

International Journal of Medical Science and Public Health, 2016

Background: Medical knowledge is expanding everyday with increasing complexity of the health-care... more Background: Medical knowledge is expanding everyday with increasing complexity of the health-care system. For that, it is important for faculty to have self-motivation for their update and self-development. Self-directed learning in today's scenario is mostly done by online learning or e-learning. Of many tools, massive open online course (MOOC) is a relatively new phenomenon blooming the adult learning. They fill the role of continuous education and professional development. Objective: To find out the awareness and use of MOOC and educational video series by the medical faculties. Materials and Methods: It was a questionnaire-based cross-sectional study. Thus, predesigned and pretested questionnaire forms were distributed to faculty members of a medical school. Questionnaires were about usage of information technologies and Internet tools, various messaging and discussion tools, and use of MOOC and video series by medical faculties. The filled up forms were collected, and statistical analysis was done by using Microsoft Excel. Result: A total of 108 faculty members participated in the study. More than 64% participants were using Internet more than 5 h per week. Among all participants, 63.89% participants were using online messaging and discussion tools such as email, google and yahoo groups, blogging, forums, and others. Awareness of MOOCs and web portal such as edX, coursera, Udacity, and others was only 18.52% (20) among the faculty members. Of them, 14 reported that they had enrolled in such courses at least once. Of 108 faculties, 25 were aware of availability of educational video series, and 22 reported using video series. Conclusion: Use of Internet and online discussion tool for educational purpose is very good among the faculty members. But, the study shows that the awareness of online learning tools such as MOOCs and educational video series are very low among faculty members. However, after some awareness program, they will start using these resources for selfdirected learning.

International Journal of Medical Science and Public Health, 2016

Background: In this era of polypharmacy in chronic disease such as hypertension and diabetes, the... more Background: In this era of polypharmacy in chronic disease such as hypertension and diabetes, there are more chances of food-drug interactions. Significant food-drug interaction can cause failure of drug therapy or serious adverse effect to patient. Objective: To assess the potential food-drug interaction (pFDI) patients attending Medicine outpatient department (OPD) at a tertiary-care teaching hospital in Valsad, Gujarat, India. Materials and Methods: The prescriptions of patients attending Medicine OPD were analyzed for demography of patients and pFDI. Freely available Drug Interaction Checker on Internet was used to analyze pFDI. Interactions were classified major, moderate, and minor according to severity and by their mechanism as pharmacokinetic or pharmacodynamic types. Statistical analysis was done using appropriate Microsoft Excel. Result: A total of 300 prescriptions were collected from study site; from those, 253 prescriptions were included in our study. From these, 128 (50.59%) were from male patients and 125 (49.41%) from female patients. The number of drugs prescribed to the individual patient was 4.4 ± 1.48 (range, 2–12). The frequency of pFDI per patient was 0.97 ± 1.03 (range, 0–5). The number of pFDI increased with increase in the age of patients and the number of drugs prescribed. Among 253 patients, 149 (59%) patients showed at least one pFDI, and 104 (41%) patients did not show pFDI. Among 243 pFDIs, 26 (10.69%) were pharmacodynamic and 217 (89.30%) pharmacokinetic types. In this study, four (1.65%) interactions were major, while those with moderate and minor severities accounted for 173 (71.19%) and 66 (27.16%), respectively. Conclusion: In this study, it was found that most of pFDIs were pharmacokinetic in nature and of moderate severity. Physician should be aware of significant food-drug interaction with food consumed by local community.

Journal of Research in Medical Education & Ethics, 2012

Animal experiments are inseparable part of medical research. Till now, advances in medical techno... more Animal experiments are inseparable part of medical research. Till now, advances in medical technology have been heavily dependent on animal experiments. The replacement of animal experiments with non-animal techniques often yields both ethical and technical advantages. Animal experiments can be replaced with alternative methods like in silico studies (computer-based) and in vitro studies (using biological components and cell cultures) which can be useful to reduce and replace animals for experiments. Despite encouraging results with such technology, there are still many areas where better understanding of disease mechanisms cannot be achieved without the use of animals although unethical animal experiments should be discouraged. Novel animal experimental models such as genetically modified and transgenic animals, zebrafish, fruitflies or roundworms, squids and microorganisms like bacteria and yeasts are useful to reduce the costs associated with mammalian models and to limit drug failures by incorporating animal studies earlier in the drug developmental process. Animal studies still have an important place in biomedical research but in academics as far as possible alternatives for these should be considered.

Journal of Pharmacology and Pharmacotherapeutics, 2011

Sugar is an inseparable part of the food we consume. But too much sugar is not ideal for our teet... more Sugar is an inseparable part of the food we consume. But too much sugar is not ideal for our teeth and waistline. There have been some controversial suggestions that excessive sugar may play an important role in certain degenerative diseases. So artifi cial sweeteners or artifi cially sweetened products continue to attract consumers. A sugar substitute (artifi cial sweetener) is a food additive that duplicates the effect of sugar in taste, but usually has less food energy. Besides its benefi ts, animal studies have convincingly proven that artifi cial sweeteners cause weight gain, brain tumors, bladder cancer and many other health hazards. Some kind of health related side effects including carcinogenicity are also noted in humans. A large number of studies have been carried out on these substances with conclusions ranging from "safe under all conditions" to "unsafe at any dose". Scientists are divided in their views on the issue of artifi cial sweetener safety. In scientifi c as well as in lay publications, supporting studies are often widely referenced while the opposing results are de-emphasized or dismissed. So this review aims to explore the health controversy over perceived benefi ts of sugar substitutes.

National Journal of Physiology, Pharmacy and Pharmacology, 2017

Background: Health-care expenses are booming nowadays. India is one of the biggest generic medici... more Background: Health-care expenses are booming nowadays. India is one of the biggest generic medicine manufacturers in all over the world still generic medicines are less prescribed in India. In the USA, 86% prescriptions contain generic medicines which saved 1.5 trillion dollars of USA consumers in the past decade. Less knowledge of generic medicine is correlated to less prescribing. Previously, studies were carried out on pharmacist and general practitioner to assess knowledge, attitude, and practice of generic medicine among them. Such study was not done on MBBS students who will be future doctors. Aims and Objectives: This study was planned with the aim of assessing knowledge, attitude, and practice of medical students toward generic medicines. Materials and Methods: This was a questioner-based cross-sectional survey kind of study. This preformed and pre-evaluated questioner was given to third semester of second year MBBS students. Questioner contains 10 items for knowledge, 10 items for attitude, and 2 items for practice. These are multiple choice kind of questions. Data were analyzed by MS Excel. Results: In this study, 110 students participated. Only 14.55% of students said that generic drugs only be marketed after expiry of patent of innovator drug. Only 27.27% of students said that generic drug manufacturer need not to repeat the preclinical studies and clinical trials as required by innovator medicines. Most of the students (65.45%) know that innovator drugs are more costly than their generic substitute. Only 23.64% of students were aware about the Government of India scheme called Jan Aushadhi whose sole purpose to set up generic drug stores in the country. Just 30.91% of participants know that patients or pharmacists are not legally empowered to sell or purchase generic medicines over innovator medicine. There were a good number of participants (54.55%) not agree with Generic drugs cost less because they are inferior to innovator (patented) drug. About 88.18% of students gave the opinion that there should be a training program to increase the awareness regarding generic drugs among doctors and patients. Nearly 81.82% of students gave the opinion that there should be a generic medicine store at every government hospital. 80% of participants had not read any article regarding the comparison of safety and efficacy of generic versus innovator (patented) drugs. Conclusion: This study showed that medical students having good knowledge, attitude about safety, efficacy, and cost of generic medicines. Students know less about government scheme such as Jan Aushadhi. They also support that patients and pharmacist are legally empowered to sell or purchase generic medicine in place of costly innovator medicines. Students also agree with there should be some change in policy by medical insurance company to improve generic drugs prescribing.

National Journal of Physiology, Pharmacy and Pharmacology, 2018

Increasing evidence has underlined the importance of oxidative stress in the Pathophysiology of h... more Increasing evidence has underlined the importance of oxidative stress in the Pathophysiology of hypertension and its contribution to the associated complications. However the correlation between oxidative stress parameters and blood pressure levels is not clearly understood. Thus present study was done to evaluate the oxidative stress parameters in patients with hypertension and to check the correlation, if any, between these parameters and systolic and diastolic blood pressure. Plasma malondialdehyde, superoxide dismutase and catalase levels were measured in sixty hypertensive and forty normotensive subjects. Pearson’s correlation analysis was performed to study the correlation between these parameters and systolic and diastolic blood pressure. Enhanced oxidative stress was observed in hypertensive subjects as denoted by raised plasma malondialdehyde levels and reduced superoxide dismutase and catalase levels. Plasma malondialdehyde correlated positively whereas superoxide dismutas...

National Journal of Physiology, Pharmacy and Pharmacology, 2019

Background: The increasing health-care expenses are a major concern for the health-care proving s... more Background: The increasing health-care expenses are a major concern for the health-care proving system in the world. As stated by the World Health Organization, in the majority of developing countries out of pocket expenses may go as high as 80% of total health-care expenditures. In developing countries like India, the generic medicines are not widely prescribed due to lack of knowledge and awareness regarding generic medicines in both prescribers and in patients. Understanding of prescriber’s attitude and perceptions regarding the quality, efficacy, and safety of generic medicines may help to identify important barriers for better generic prescribing. Aims and Objectives: The aim of the study was to assess the knowledge, attitude, and practice of generic medicines among intern doctors at a tertiary care teaching hospital. Materials and Methods: A prospective, cross-sectional study was conducted among intern doctors at a tertiary care teaching hospital using a questionnaire, consisting of questions related to knowledge, attitude, and practice regarding generic medicines. Data were analyzed by MS Excel. Results: A total of 105 (88%) interns responded to the questionnaire. Around 60% of interns agreed with that generic medicine can be used in place of innovator (patented) medicine. Among all the interns, 52.4% were aware of that generic medicine contains the same active ingredient as their counterpart innovator medicine. More than half of interns (55.2 %) were aware of Jan Aushadhi scheme launched by the Government of India. Around 69.5% of interns disagreed with that generic medicines cost less because they are inferior to innovator medicines. Majority of interns (88.6%) were of the opinion that there should be some training session to raise the knowledge and awareness about generic medicines. Around half of the interns (50.5%) had never switch a patient on innovator medicine to generic medicine. Only 1% was not in favor of supporting generic drug prescribing. Conclusion: Knowledge of intern doctors regarding concept and regulations about generic drugs is adequate. Although they prescribe a good number of generic drugs, concerns regarding quality, efficacy, safety, availability, and awareness are present among them. Hence, mass awareness programs and training sessions are required to address these concerns which may alter their prescribing behavior and can encourage for more use of generic medicines.

International Journal of Medical Science and Public Health, 2016

Background: Medical knowledge is expanding everyday with increasing complexity of the health-care... more Background: Medical knowledge is expanding everyday with increasing complexity of the health-care system. For that, it is important for faculty to have self-motivation for their update and self-development. Self-directed learning in today's scenario is mostly done by online learning or e-learning. Of many tools, massive open online course (MOOC) is a relatively new phenomenon blooming the adult learning. They fill the role of continuous education and professional development. Objective: To find out the awareness and use of MOOC and educational video series by the medical faculties. Materials and Methods: It was a questionnaire-based cross-sectional study. Thus, predesigned and pretested questionnaire forms were distributed to faculty members of a medical school. Questionnaires were about usage of information technologies and Internet tools, various messaging and discussion tools, and use of MOOC and video series by medical faculties. The filled up forms were collected, and statistical analysis was done by using Microsoft Excel. Result: A total of 108 faculty members participated in the study. More than 64% participants were using Internet more than 5 h per week. Among all participants, 63.89% participants were using online messaging and discussion tools such as email, google and yahoo groups, blogging, forums, and others. Awareness of MOOCs and web portal such as edX, coursera, Udacity, and others was only 18.52% (20) among the faculty members. Of them, 14 reported that they had enrolled in such courses at least once. Of 108 faculties, 25 were aware of availability of educational video series, and 22 reported using video series. Conclusion: Use of Internet and online discussion tool for educational purpose is very good among the faculty members. But, the study shows that the awareness of online learning tools such as MOOCs and educational video series are very low among faculty members. However, after some awareness program, they will start using these resources for selfdirected learning.

International Journal of Medical Science and Public Health, 2016

Background: In this era of polypharmacy in chronic disease such as hypertension and diabetes, the... more Background: In this era of polypharmacy in chronic disease such as hypertension and diabetes, there are more chances of food-drug interactions. Significant food-drug interaction can cause failure of drug therapy or serious adverse effect to patient. Objective: To assess the potential food-drug interaction (pFDI) patients attending Medicine outpatient department (OPD) at a tertiary-care teaching hospital in Valsad, Gujarat, India. Materials and Methods: The prescriptions of patients attending Medicine OPD were analyzed for demography of patients and pFDI. Freely available Drug Interaction Checker on Internet was used to analyze pFDI. Interactions were classified major, moderate, and minor according to severity and by their mechanism as pharmacokinetic or pharmacodynamic types. Statistical analysis was done using appropriate Microsoft Excel. Result: A total of 300 prescriptions were collected from study site; from those, 253 prescriptions were included in our study. From these, 128 (50.59%) were from male patients and 125 (49.41%) from female patients. The number of drugs prescribed to the individual patient was 4.4 ± 1.48 (range, 2–12). The frequency of pFDI per patient was 0.97 ± 1.03 (range, 0–5). The number of pFDI increased with increase in the age of patients and the number of drugs prescribed. Among 253 patients, 149 (59%) patients showed at least one pFDI, and 104 (41%) patients did not show pFDI. Among 243 pFDIs, 26 (10.69%) were pharmacodynamic and 217 (89.30%) pharmacokinetic types. In this study, four (1.65%) interactions were major, while those with moderate and minor severities accounted for 173 (71.19%) and 66 (27.16%), respectively. Conclusion: In this study, it was found that most of pFDIs were pharmacokinetic in nature and of moderate severity. Physician should be aware of significant food-drug interaction with food consumed by local community.

Journal of Research in Medical Education & Ethics, 2012

Animal experiments are inseparable part of medical research. Till now, advances in medical techno... more Animal experiments are inseparable part of medical research. Till now, advances in medical technology have been heavily dependent on animal experiments. The replacement of animal experiments with non-animal techniques often yields both ethical and technical advantages. Animal experiments can be replaced with alternative methods like in silico studies (computer-based) and in vitro studies (using biological components and cell cultures) which can be useful to reduce and replace animals for experiments. Despite encouraging results with such technology, there are still many areas where better understanding of disease mechanisms cannot be achieved without the use of animals although unethical animal experiments should be discouraged. Novel animal experimental models such as genetically modified and transgenic animals, zebrafish, fruitflies or roundworms, squids and microorganisms like bacteria and yeasts are useful to reduce the costs associated with mammalian models and to limit drug failures by incorporating animal studies earlier in the drug developmental process. Animal studies still have an important place in biomedical research but in academics as far as possible alternatives for these should be considered.

Journal of Pharmacology and Pharmacotherapeutics, 2011

Sugar is an inseparable part of the food we consume. But too much sugar is not ideal for our teet... more Sugar is an inseparable part of the food we consume. But too much sugar is not ideal for our teeth and waistline. There have been some controversial suggestions that excessive sugar may play an important role in certain degenerative diseases. So artifi cial sweeteners or artifi cially sweetened products continue to attract consumers. A sugar substitute (artifi cial sweetener) is a food additive that duplicates the effect of sugar in taste, but usually has less food energy. Besides its benefi ts, animal studies have convincingly proven that artifi cial sweeteners cause weight gain, brain tumors, bladder cancer and many other health hazards. Some kind of health related side effects including carcinogenicity are also noted in humans. A large number of studies have been carried out on these substances with conclusions ranging from "safe under all conditions" to "unsafe at any dose". Scientists are divided in their views on the issue of artifi cial sweetener safety. In scientifi c as well as in lay publications, supporting studies are often widely referenced while the opposing results are de-emphasized or dismissed. So this review aims to explore the health controversy over perceived benefi ts of sugar substitutes.

National Journal of Physiology, Pharmacy and Pharmacology, 2017

Background: Health-care expenses are booming nowadays. India is one of the biggest generic medici... more Background: Health-care expenses are booming nowadays. India is one of the biggest generic medicine manufacturers in all over the world still generic medicines are less prescribed in India. In the USA, 86% prescriptions contain generic medicines which saved 1.5 trillion dollars of USA consumers in the past decade. Less knowledge of generic medicine is correlated to less prescribing. Previously, studies were carried out on pharmacist and general practitioner to assess knowledge, attitude, and practice of generic medicine among them. Such study was not done on MBBS students who will be future doctors. Aims and Objectives: This study was planned with the aim of assessing knowledge, attitude, and practice of medical students toward generic medicines. Materials and Methods: This was a questioner-based cross-sectional survey kind of study. This preformed and pre-evaluated questioner was given to third semester of second year MBBS students. Questioner contains 10 items for knowledge, 10 items for attitude, and 2 items for practice. These are multiple choice kind of questions. Data were analyzed by MS Excel. Results: In this study, 110 students participated. Only 14.55% of students said that generic drugs only be marketed after expiry of patent of innovator drug. Only 27.27% of students said that generic drug manufacturer need not to repeat the preclinical studies and clinical trials as required by innovator medicines. Most of the students (65.45%) know that innovator drugs are more costly than their generic substitute. Only 23.64% of students were aware about the Government of India scheme called Jan Aushadhi whose sole purpose to set up generic drug stores in the country. Just 30.91% of participants know that patients or pharmacists are not legally empowered to sell or purchase generic medicines over innovator medicine. There were a good number of participants (54.55%) not agree with Generic drugs cost less because they are inferior to innovator (patented) drug. About 88.18% of students gave the opinion that there should be a training program to increase the awareness regarding generic drugs among doctors and patients. Nearly 81.82% of students gave the opinion that there should be a generic medicine store at every government hospital. 80% of participants had not read any article regarding the comparison of safety and efficacy of generic versus innovator (patented) drugs. Conclusion: This study showed that medical students having good knowledge, attitude about safety, efficacy, and cost of generic medicines. Students know less about government scheme such as Jan Aushadhi. They also support that patients and pharmacist are legally empowered to sell or purchase generic medicine in place of costly innovator medicines. Students also agree with there should be some change in policy by medical insurance company to improve generic drugs prescribing.