Bodhankar S.L.,Bharati Vidyapeeth Deemed University
Asian Pacific Journal of Tropical Disease | Year: 2012
Objective: Arthritis is a severe debilitating chronic disease. The objective of the present investigation was to evaluate the clinical outcome and cost effectiveness of anti-rheumatoid arthritis regimen for the treatment of arthritis. Methods: The patients were classified into three treatment cohorts on the basis of the treatment regimens prescribed by the physicians. These were group I consisting of patients treated with monotherapy of non-steroidal anti- inflammatory drugs alone, group II consisting of patients treated with disease modifying anti rheumatoid drugs + non-steroidal anti- inflammatory drugs and group III consisting of patients treated with disease modifying anti rheumatoid drugs along with oral Corticosteroids. The patient reported outcome was measured using European questionnaire 5 dimension 3 levels (EQ-5D-3L) and European questionnaire visual analogue scale (EQ-VAS) before and after the treatment regimen. Clinical outcome was measured using Clinical disease activity index (CDAI). The details of costs were recorded by interviewing the patients. Results: The patient reported outcome measured by EQ-5D-3L and EQ-VAS was significantly improved in patients belonging to group III when compared to group II (P < 0.05) and I (P < 0.001) respectively. The outcomes of CDAI scores demonstrate that the mean change in CDAI levels was 7.04, 12.01 and 16.98 in group I, II and III respectively. Total cost incurred per patient was found to be equal to Rs. 1120 ($19.6) in group I, Rs. 1685 ($29.49) in group II and Rs. 2465 ($43.14) in group III. The ACER was determined as 159.09 in group I, 140.299 in group II and 145.17 in group III. Conclusion: Amelioration of arthritis in clinics can be effectively measured by validated instruments (EQ-5D-3L, EQ-VAS, CDAI) and DMARDs along with NSAIDs are the most cost effective therapy for treatment of arthritis. © 2012 Asian Pacific Tropical Medicine Press.
Dhobale M.,Bharati Vidyapeeth Deemed University
International Journal of Developmental Neuroscience | Year: 2014
Proper placental development is essential during pregnancy since it forms the interface between the maternal-foetal circulations and is critical for foetal nutrition and oxygenation. Neurotrophins such as nerve growth factor (NGF), brain derived neurotrophin (BDNF), neurotrophin-3 (NT-3) and neurotrophin-4/5 (NT-4/5) are naturally occurring molecules that regulate development of the placenta and brain. BDNF and NGF also involved in the regulation of angiogenesis. Recent studies suggest that the levels of BDNF and NGF are regulated by docosahexaenoic acid (DHA) which is an important omega-3 fatty acid and is a structural component of the plasma membrane. Oxidative stress during pregnancy may lower the levels of DHA and affecting the fluidity of the membranes leading to the changes in the levels and expression of BDNF and NGF. Therefore altered levels and expression of NGF and BDNF may lead to abnormal foetal growth and brain development that may increase the risk for cardiovascular disease, metabolic syndromes and neurodevelopmental disorders in children born preterm. This review discuss about the neurotrophins and their role in the feto-placental unit during critical period of pregnancy. © 2014 ISDN.
Dhaneshwar S.S.,Bharati Vidyapeeth Deemed University
World Journal of Gastroenterology | Year: 2014
Despite the advent of biological products, such as antitumor necrosis factor-α monoclonal antibodies (infliximab and adalimumab), for treatment of moderate to severe cases of inflammatory bowel disease (IBD), most patients depend upon aminosalicylates as the conventional treatment option. In recent years, the increased knowledge of complex pathophysiological processes underlying IBD has resulted in development of a number of newer pharmaceutical agents like low-molecular- weight heparin, omega-3 fatty acids, probiotics and innovative formulations such as high-dose, oncedaily multi-matrix mesalamine, which are designed to minimize the inflammatory process through inhibition of different targets. Optimization of delivery of existing drugs to the colon using the prodrug approach is another attractive alternative that has been utilized and commercialized for 5-aminosalicylic acid (ASA) in the form of sulfasalazine, balsalazide, olsalazine and ipsalazine, but rarely for its positional isomer 4-ASA - a wellestablished antitubercular drug that is twice as potent as 5-ASA against IBD, and more specifically, ulcerative colitis. The present review focuses on the complete profile of 4-ASA and its advantages over 5-ASA and colon-targeting prodrugs reported so far for the management of IBD. The review also emphasizes the need for reappraisal of this promising but unexplored entity as a potential treatment option for IBD. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
Dhaneshwar S.S.,Bharati Vidyapeeth Deemed University
Inflammation & allergy drug targets | Year: 2014
Disease modifying antirheumatic drugs (DMARDs) is a category of drugs which is used as medication in various arthritic conditions to arrest the progression of disease along with relief from pain. About 83% of population worldwide uses DMARDs. Withdrawal of COX-2 inhibitors because of cardiovascular side effects and short-term action associated with glucocorticoids provided a motivation for development of newer DMARDs. Currently non- biological DMARDs like methotrexate, sulfasalazine, hydroxychloroquine and azathioprine serve the purpose of relieving pain and inhibiting the progression of disease. Biological DMARDs like toclizumab, adalimumab, infliximab, golimumab and abatacept have shown more efficacy and lesser side effects as compared to non- biological DMARDs but their access to patient is less because of higher cost. DMARDs act by different mechanisms against inflammation like inhibition of tumor necrosis factor, suppression of IL-1 and TNF-α, induction of apoptosis of inflammatory cells, by increasing chemotactic factors, inhibition of purine synthesis, pyrimidine metabolism or purine embolism. DMARDs have important applications in diseases like rheumatoid arthritis, Crohn's disease, juvenile idiopathic arthritis, psoriatic arthritis and myasthenia gravis. Present review mainly focuses on DMARDs and their clinical applications giving an overview of their mechanism of action, pharmacokinetic properties, advantages over conventional therapies, shortcomings and recent trends.
Halli R.,Bharati Vidyapeeth Deemed University
The Journal of craniofacial surgery | Year: 2012
The technique of approximating tissues resulting in minimal amount of scar usually requires skillful suturing techniques by the surgeons, especially in cleft lip repair. Increased awareness and demand for aesthetic surgical correction with quality in tissue closure has led to the invention of new materials and techniques. Amcrylate (iso amyl 2-cyanoacrylate) is retrospectively evaluated as tissue glue in cleft lip repair, and the results are compared with skin closure by 6-0 Prolene. A retrospective analysis of 60 patients with unilateral or bilateral cleft lip repair was carried out to compare the results of skin closure with Amcrylate and 6-0 Prolene. Patients were randomly divided into 2 groups, each group containing 30, and the study was designed to evaluate the quality of scars after the use of Amcrylate tissue adhesive to close the skin during cleft lip repair and its advantages over sutures (6-0 Prolene). Both groups were analyzed for the time taken for skin closure, resultant scar, parental satisfaction, and complications, and the results were found to be statistically significant for the Amcrylate group. Amcrylate, when used as tissue glue for skin closure in cleft lip repair, definitely has an edge over conventional suturing techniques.