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Objectives: There is a worldwide epidemic of type 2 diabetes mellitus (T2DM). It is associated with cardiovascular autonomic neuropathy. Heart rate variability (HRV) is the gold standard for its measurement. Thus, effect of metformin therapy on HRV was evaluated in newly diagnosed T2DM patients. Methods: This was a prospective and observational study carried out from January 2020 to September 2021 in the medicine outpatient department of a tertiary care hospital in Gujarat, India. The study included newly diagnosed T2DM patients of both genders aged 18–70 years. Baseline HRV parameters were recorded by performing electrocardiogram for a fixed duration of 5 min. Follow-up was done after 6 months of metformin 500 mg monotherapy. Time domain analysis was done using square root of mean square of successive R-R interval difference (RMSSD) and frequency domain analysis was done using low-frequency/high-frequency (LF/HF) ratio. Paired t-test was used for analysis. p

A newly imidazolium linked chalcone ionic LCs (5a-5f) based on two phenyl rings have been synthesized by the quaternization of 1-methylimidaazole and 3,4,-dialkoxy substituted chalcone derivatives. The mesomorphic properties of these compounds were observed by optical polarized light microscopy (POM) and confirmed by differential scanning calorimetry (DSC) analysis. All synthesized compounds exhibited mesogenic properties on heating and cooling condition. Thermal stability of smectic and nematic phase of present ILCs are higher as compared to series-1. Their chemical structures were identified by using 1H NMR and IR spectroscopy.

Background: Nowadays, students have a vast knowledge of multimedia. Social media is an online platform that allows community building through collaboration. Objectives: The present study aimed to understand the use of web-based resources for educational purposes by medical students. Methods: This cross-sectional survey was conducted for three months on the students, interns, and residents of a tertiary care hospital and Government Medical College, Surat, India. Informed consent was taken from the participants, and a pre-approved questionnaire was delivered to all of them for data collection. The data were entered using the Google spreadsheet and were expressed using descriptive statistics. Results: Out of the study population consisting of 900 individuals, 646 filled the questionnaires and were finally evaluated. Out of 646, 430 individuals were medical students, 335 were female, and 303 were male. The majority (91.9%) of the responders were exposed to computer education in their schools. We found that 549 (86.4%) people were aware of the free internet access provided to them in the college library. Almost 97% (617) of the responders had mobile phones with internet access, and 80.1% connected to the internet more than once a day. The results of this study showed that 94.4% of the participants accepted that they used internet-based media to enhance their academic knowledge, while 66.5% agreed that internet resources are giving much unreliable information. Moreover, 55.8% of the responders were associated with the academic e-learning groups. Only 55 (8.7%) respondents had received formal training for online literature search. Conclusions: The emergence of various social media applications and web-based resources provides us with more collaborative approaches to medical education. However, implementing new technologies also creates new challenges and opportunities for students and faculties. Training concerning internet search and web-based resources is important to enhance their e-learning skills.

Background: Generic drugs are the painstaking solution to deal with out of pocket expenditure however, the impact has not yet been seen in India. Thus, to understand the facilitators and barriers, this study aimed to gather evidence on the perception of the acceptability of generic drugs among patients, pharmacists, and physicians. Methods: The key informant interviews (KII) were conducted during 2017-2018 in Gujarat, India. A total of 25 (9 patients, 8 pharmacists, 8 physicians) KIIs were included in the thematic analysis. Results: Most of the patients knew about cheaper drugs are available in the market, but they perceived that those meant for poor people. Pharmacists talked about the profit from branded drugs are higher than generics. Pharmacist and doctors expressed concern for the efficacy of generic drugs, as it requires more visits to hospitals. Patients usually report more side effects if using generic drugs, apart from that poor packaging and lack of trust on generic also remained an issue in terms of satisfaction. Pharmacist and patients are both expressed their reliance on doctors suggestion and prescription; however, doctors are really not in favour to prescribe generics. The ethical dilemma remained with the pharmacists in not suggesting generics as an alternative to the branded drugs. Conclusion: The study concludes that cost is the main perception of patients, pharmacists, and physicians, however; the decision power lies with the pharmacist and doctors, which is mainly not in favour to use or promote the generic drugs even if the cost is low because of efficacy and satisfaction issues.

Background: Generic drugs (Generics) are low cost, equal efficacy alternatives to the branded drugs. Generics are medicines on which patents have expired. They are sold either as branded products or as unbranded products under generic names. These generic names are internationally agreed short names called International Non-Proprietary Names. Due to its low cost, it reduces the overall expenditure for patient care. Government of India (GOI) has been pushing to increase the prescription practice of doctors for generics and acceptability of generic in the community. Present study assesses the current opinion of patients about the generics and documents factors affecting the knowledge, perception and opinion about the generics. Objectives: Present study was designed to investigate about the opinion of patients about the generics and to document different factors associated with their perceptions. Materials and Methods: A pre-validated pre-tested questionnaire was used to collect the data from patients attending various outpatients in a Tertiary Care hospital in Jodhpur. Trained Research Associate visited various Out Patient Department (OPD) of different specialties for two consecutive days to seek consent and collected data from the patients visiting the OPD and consented to participate. Patient’s knowledge, prior experience of use and general opinion about the generics was gathered. Descriptive statistics was used in the form of frequency and percentages. Results: Out of the 643 patients, 147 (22.9%) had heard about the generics. Out of the different sociodemographic predictors, age with a class intervals 45 years-55 years (OR – 2.52), 55 years -65 years (OR – 3.26) and > 65 years (OR –3.09) and educational qualifications namely higher secondary (OR – 3.07) and graduation (OR – 5.98) were found to be the statistically significant predictors for the opinion on generics; however, gender, marital status, family income and occupation were not significant statistically. Out of the 147 patients who had heard about the generics only 38% had used them in last six months, 65.8% agreed that generics are safe and 36.7% opined that generics are as effective as branded drugs. Around 44% of the patients disagreed that generics have more side effects. On inquiring about the most common reason for no usage of the generic drug, distrust on the efficacy was found to be the most common one. Conclusion: Majority of patients had never heard about the generic drugs. Age and Education were the positive predictors for better awareness about the generic drugs. Patients perception for generics can be changed with better advocacy as well as informed prescription by the treating physicians. Key words: Generic Drugs, Brand Drugs, Opinion, Patients, Physicians, India.

A novel experimental scheme for real time measurement of aluminum oxide film during anodization was developed for the first time. The scheme was established based on a combination of a fiber optic sensor of FabryâPérot interferometry and direct current (DC) electrochemical methods. The scheme was assembled in a way to simultaneously anodize the aluminum samples and to measure the thickness of the aluminum oxide film. The anodization process of aluminum sample was carried out in 4% sulfuric acid (H2SO4) solution by the DC methods at room temperature. The estimated thickness of the aluminum oxide film by the novel scheme was verified by scanning electron microscopy (SEM) and electrochemistry measurements. This study shows that real time measurement of the thickness of aluminum oxide film is feasible as it closely matched the thickness determined by SEM and other electrochemistry techniques. Keywords: Aluminum, Aluminum oxide film, FabryâPérot interferometry, Sulfuric acid, Scanning electron microscopy (SEM), Direct current (DC) electrochemical methods

Epilepsy is a chronic disorder of brain caused by various factors which may vary according to the patient age. In epilepsy threshold for seizure generation get reduced. It may affect patient’s living and increases morbidity. Anti-epileptic drugs are given as mono or poly-therapy for seizure control. These anti-epileptics produce side-effects which are dose and duration of the treatment dependent. One of the important side effects is impact on cognitive function of the patient. However, some anti-epileptic medications also cause improvement in the cognitive function. Newer anti-epileptics are providing better compliance and impact as compared to older ones. This review article provides details of impact of anti-epileptic drugs on cognitive functioning.

Background: Generic drugs are low-cost alternatives to branded drugs. The government of India is encouraging physicians to prescribe the generics to decrease out-of-pocket expenditure of health care. Looking at India's low-prescription on generic drugs, it is crucial to analyze the factors responsible for it. A patient's unawareness may be an important factor; hence, it should be evaluated systematically. Objectives: This study was designed with the aim of assessing knowledge and perception of generics among patients visiting the outpatient department of primary care physicians at the Patan city of Gujarat. Material and Methods: A trained research associate visited the OPDs of various general practitioners to collect the data. A prevalidated questionnaire was administered to these patients. The data was analyzed with the help of statistical software. Descriptive statistics were used to analyze the data. Results: Among 345 patients, only 33.6% reportedly heard about generics. Of these only a few patients (60%) believed that generics are safe. Those who were not willing to take generics reported efficacy as the major concern. Out of various factors that may affect knowledge of generic drugs, young age (OR = 5.3) and education (Primary (OR = 8.01), Secondary (OR = 6.19), and Higher secondary (OR = 3.07) were statistically significant. Conclusion: Awareness about the generic drugs was low among the patients visiting the primary care physician. The young age and primary and secondary education levels were significantly associated with the awareness regarding generics.

Bipolar disorder (BD) is a chronic disorder which usually has its onset in early adulthood. At one end of the spectrum is depression and at other is mania. Like many psychiatric illnesses, it is not treatable but its symptoms are completely manageable with medications. Commonly used drugs are mood stabilizers and atypical antipsychotics along with adjunctive medications such as anxiolytics and antidepressants. In general, a combination of these drugs is used for treatment. These drugs have significant adverse effects which add to the burden of the disease. Presently, there are 11 US Food and Drug Administration - approved drugs for management of acute mania, 3 for bipolar depression and 7 for bipolar maintenance. This review article details the use of these drugs in BD.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the benefits and harms of adding a new drug to the current triple‐drug regimen for management of resistant hypertension in adults versus continuation of treatment with triple‐drug therapy alone.

Necrotizing enterocolitis (NEC ≥ Stage II) is associated with high mortality and morbidity in preterm infants. To assess if introduction of standardized feeding regimen (SFR) and routine probiotic supplementation (RPS) was associated with reduced incidence of NEC in preterm infants in our nursery in a resource limited set up. This was a retrospective cohort study assessing the incidence of NEC ≥ Stage II before (Epoch 1: N = 144) vs. after (Epoch 2, N = 144) implementation of SFR and RPS in preterm infants

Introduction: Bipolar disorder is a chronic, debilitating psychiatric disorder. Mood stabilizers and atypical antipsychotics are first line drugs for bipolar disorder. They have significant adverse effects. Aim: The study was conducted with an aim to evaluate the pattern of occurrence of Adverse Drug Reactions (ADRs) in the patients with bipolar disorder and to assess their causality, severity and preventability. Materials and Methods: A prospective and observational study - carried out in the psychiatry outpatient department of New Civil Hospital, Surat for 15 months. All patients diagnosed with bipolar disorder and receiving pharmacotherapy were included. Udvalg for Kliniske Undersøgelser (UKU) side effect rating scale and Abnormal Involuntary Movement Scale (AIMS) were used for documenting ADRs and tardive dyskinesia, respectively. Assessment of causality, severity and preventability of recorded ADRs was done using Naranjo’s algorithm and WHO-UMC scale, modified Hartwig and Seigel Scale and modified Schumock and Thornton scale, respectively. Descriptive statistics was used (percentage, mean±standard deviation) for presentation of demographics and other numerical data; Chi Square test and Fisher’s exact test were used to assess association between variables. A p-value < 0.05 was considered significant. Results: A total of 703 ADRs were recorded from 175 patients. The most common ADRs observed were asthenia (11.95%) and sedation (10.24%). Majority of ADRs were mild on assessment with UKU scale. Mood stabilizers (59.46%) were most frequently associated with ADRs and lithium was most common single drug responsible. Upon causality assessment, majority of the reactions were probable (54.77% with WHO-UMC scale, and 56.33% with Naranjo’s algorithm). The association of results between the two scales was statistically significant (p

Background: Pediatric population is having high chances of drug-drug interactions (DDIs) because off-label use of drugs, weight-based dose adjustments, and pharmacokinetically, they are different from adult population. Hospitalized pediatric population is more vulnerable to face adverse consequences reserve physiology, medication dosing errors and polypharmacy. Thus, chances are more of potential DDIs (pDDIs) in pediatric patients. There has been focus mainly on adult population, less studies regarding DDIs or pDDIs in pediatric population have been documented. Aims and Objectives: The primary objective of the study is to identify pDDIs in pediatric patients. Determining prevalence, types of pDDIs, and factors associated with pDDIs are secondary objective. Materials and Methods: A prospective, observational study was conducted in pediatric ward of tertiary care hospital during April 2018–August 2018. The principal investigator collected the data from hospital case papers and recorded in pre-tested case record form. Drugs prescribed in each patient were assessed using Lexicomp software (version 4.4.0), which is internet-based free software used to predict pDDIs. DDIs were categorized in minor, moderate, and major according to their severity assessed by software. If necessary, the investigator also interviewed patients or caretaker to gather information. Results: A total of 300 patients were included during the study period. Among them, 157 (52.3%) were boys and 143 (48%) were girls. A total number of pDDIs were 235 (78%), of which 227 (97%) were minor and 3 (1.2%) were major DDIs. The most common DDI was between ondansetron and paracetamol (224). A potential major DDIs were observed between ondansetron and dextromethorphan (2) and ondansetron and phenytoin (1). Conclusion: The most common DDIs occurred with ondansetron and paracetamol, which were minor in severity. There were no clinical DDIs. Not all patients with major or moderate DDIs were suffered clinically but better to take due precautions to avoid adverse consequences.

Background: Epilepsy, the third most common neurologic disorder, deteriorates cognitive functions of the patients. Approximately 1% of the world’s population is suffering from epilepsy. Opinions regarding impact of anti-epileptic drugs on cognition are divided. So, this study was designed to assess the impact of anti-epileptic drugs on cognitive performance of patients with complex partial seizure and generalized tonic clonic seizure in Department of Medicine, at Government Medical College, Surat, Gujarat, India.Methods: In present study, cognitive functions were assessed in 50 patients of newly diagnosed complex partial seizure and generalized tonic clonic seizure coming to the Department of Medicine, Surat. The cognitive functions were evaluated by Addenbrooke’s Cognitive Examination (ACE)-III, which assessed memory, attention, fluency, language and visuo-spatial abilities. Follow-up was done after six months of baseline.Results: Baseline and Follow-up data from 50 patients were analysed. Patient treated with anti-epileptic drugs showed significant improvement in memory, attention, language and visuo-spatial abilities whereas improvement in fluency was not significant. Paired t-test and Wilcoxon Signed Ranks Test were used to analyse the data. For statistical analysis of data SPSS 19.0 software was used.Conclusions: The available data indicate that the anti-epileptic drugs on short-term administration do not adversely affect cognitive function in patients with newly diagnosed CPS and GTCS. Importantly, the data suggest that the effects exerted by AEDs could depend on factors linked to patient characteristics and individual susceptibility and to comment on those factors further studies are needed.

Background: A number of studies have been carried out in India and worldwide reporting different incidence rates of surgical site infections (SSIs), various pathogens isolated, and their antibiotic sensitivity pattern. The difference incidence rates of SSIs may be due to differences in the hospital set-up, preventive measures taken and the prophylactic use of antibiotics. Even in the same hospital, the same type of survey at different periods may report different incidence rates of SSIs depending on prevailing conditions at the time of survey. Aims and Objectives: To find out the current rate of incidence of SSI with common pathogen causing SSI and their susceptibility pattern in Sir Sayajirao General Hospital (SSGH), Vadodara. Materials and Methods: This prospective study included 953 patients undergoing major operations in major surgical departments of Shri Sayajirao General Hospital, Vadodara over a period of 8-month. Results: Out of 953 patients, 35 developed clinical signs and symptoms suggesting SSI (3.67%). Out of these 35 cases, no pathogen was isolated from 22 cases which may be due to subjective errors in collection and processing of samples. The predominant organisms isolated were Gram-negative organisms (84.6%), while Staphylococcus aureus-the only Gram-positive organism isolated contributed 15.4%. Imipenem, ampicillin+sulbactam, cefotaxime, and amikacin were the most sensitive antibiotic for Gram-negative organisms. Vancomycin, cloxacillin, oxacillin, and amoxicillinclavulanic acid combination were most sensitive antibiotic for Gram-positive organisms. Most of the commonly used antibiotics have got resistance for isolated organisms. Among them, the predominant is cefazolin, chloramphenicol, ofloxacin (OFX), erythromycin, roxithromycin and penicillin for Gram-positive organisms and netilmicin, tobramycin, piperacillin, OFX and gatifloxacin for Gram-negative organisms. Conclusion: Regarding SSI, nowadays there is a trend toward comparative studies in the same hospital over years. In SSGH, Vadodara, there is a decrease in rate of incidence of SSI over years.

Objectives Published negative studies should have the same rigour of methodological quality as studies with positive findings. However, the methodological quality of negative versus positive studies is not known. The objective was to assess the reported methodological quality of positive versus negative studies published in Indian medical journals. Design A systematic review (SR) was performed of all comparative studies published in Indian medical journals with a clinical science focus and impact factor >1 between 2011 and 2013. The methodological quality of randomised controlled trials (RCTs) was assessed using the Cochrane risk of bias tool, and the Newcastle-Ottawa scale for observational studies. The results were considered positive if the primary outcome was statistically significant and negative otherwise. When the primary outcome was not specified, we used data on the first outcome reported in the history followed by the results section. Differences in various methodological quality domains between positive versus negative studies were assessed by Fisher9s exact test. Results Seven journals with 259 comparative studies were included in this SR. 24% (63/259) were RCTs, 24% (63/259) cohort studies, and 49% (128/259) case–control studies. 53% (137/259) of studies explicitly reported the primary outcome. Five studies did not report sufficient data to enable us to determine if results were positive or negative. Statistical significance was determined by p value in 78.3% (199/254), CI in 2.8% (7/254), both p value and CI in 11.8% (30/254), and only descriptive in 6.3% (16/254) of studies. The overall methodological quality was poor and no statistically significant differences between reporting of methodological quality were detected between studies with positive versus negative findings. Conclusions There was no difference in the reported methodological quality of positive versus negative studies. However, the uneven reporting of positive versus negative studies (72% vs 28%) indicates a publication bias in Indian medical journals with an impact factor of >1.