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Palappallil D.S.,Government TD Medical College | Gangadhar R.,Sree Mookambika Institute of Medical science
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: The goal of teaching medical undergraduates Pharmacology is to form a sound foundation of therapeutics. The pharmacology record books are maintained as a part of the curriculum. The purpose of this study was to obtain feedback of the medical students about the new record adopted in the institution after major revision Materials and Methods: This was a questionnaire based study done in a Government Medical College of Kerala in February 2013. The data was analysed using SPSS. The feedback on clinical pharmacology exercises was given positive and negative scores. Results: Majority (64.5%) opined that the content in pharmacology record was good. A total of 78.1% completed the record during discussions in practical classes. Majority wrote the records for understanding pharmacology. For 79.8% General Pharmacology exercises were most relevant, 33.8% considered Clinical Pharmacology exercises to be the most thought provoking. Drug use in special groups received the maximum positive score. Conclusion: The new improved pharmacology record is an effective teaching-learning method. Inclusion of more clinically oriented exercises has increased the interest of the students in the subject. © 2015, Journal of Clinical and Diagnostic Research. All rights Reserved.

Reshmi R.,Government TD Medical College | Leena P.,Government Medical College | Pisharody R.,Government Medical College
Biomedicine (India) | Year: 2014

Introduction: Cardiovascular diseases (CVD) are the major cause of morbidity and mortality in Chronic Kidney disease (CKD) patients.Aim: In this case control study the association of hyperlipidaemia in CKD and its role as a predictor of CVD in CKD was studied.Materials and Method: This case control study (cases-63, control-21) was done in stage 3,4,5 of CKD to assess the association between GFR (glomerular filtration rate) HDL, LDL, TG, Total cholesterol, Diastolic and systolic BP.Results: Statistical analysis using ANOVA and logistic regression analysis showed a significant association between the lipid profile, BP, GFR and the various stages of CKD.Conclusion: On the basis of the observations it was concluded that hyperlipidaemia progresses with stages of CKD, but none of the variables of lipid profile acts as an independent predictor. Hence early treatment and screening for hyperlipidaemia should be started in CKD. As this study does not show lipid profile as an independent risk factor, more research is required in this field to identify other risk factors for CVD in CKD.

Sathyamurthy I.,Interventional Cardiologist | Alex S.,Formerly Fellow in Cardiology | Alex S.,Government TD Medical College
Indian Heart Journal | Year: 2015

Calcific aortic valve disease (CAVD) is the most common valvular heart disease in the elderly. As life expectancy increases, prevalence of CAVD is expected to rise. CAVD is characterized by progressive dystrophic calcification of aortic cusps. In the initial stages, the pathogenesis is similar to atherosclerosis, characterized by basement membrane disruption, inflammation, cell infiltration, lipid deposition, and calcification. Presence of osteopontin in calcified aortic valves suggests pathological calcification and bone formation in these calcified valves. Historical, experimental, genetic, and clinical evidences suggest that CAVD and atherosclerosis share the same pathological sequences with common risk factors. Understanding the two faces of atherosclerosis, the vascular and valvular, will help us to prevent progression of aortic sclerosis to aortic stenosis, by controlling modifiable risk factors and by initiating statin therapy in them. However, the knowledge about these preventive measures and drugs is scanty. In this review article, an attempt is made to unfurl the relation between atherosclerosis and CAVD. © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Palappallil D.S.,Government TD Medical College
Journal of Clinical and Diagnostic Research | Year: 2015

Introduction: There are several conflicting recommendations on the use of antibiotics in snakebite victims. This study aimed to identify the pattern of antibiotics used following snake envenomation in a tertiary care hospital of Kerala. Materials and Methods: Retrospective review of case records from January to August 2011 was done and all the cases filed as snakebite were reviewed and details entered in a structured performa. Data was analysed using SPSS 16 and results were expressed mainly using descriptive statistics. Results: Three hundred and thirteen cases were evaluated with mean age 37.58± 14.54 year and 51.1% were males. Out of total, 94.6% received antibiotics of which 88.85% were oral, 8.1% parenteral and 3.04% both. There were total 454 prescriptions of antibiotics. In all seven different types of antibiotics were prescribed alone or in combination of which Ampicillin (205) was the commonest followed by Cloxacillin (194). The mean antibiotic usage was 1.46±0.716 per patient and the mean duration of antibiotic use was 3.16±1.446 days. In patients with no envenomation the mainly prescribed antibiotic was Cloxacillin (126). Intravenous antibiotics like Piperacillin plus Tazobactam were given only in patients with either local or systemic envenomation. Conclusion: The main pattern of use of antibiotics following snakebite envenomation is Ampicillin alone or in combination empirically, Cloxacillin prophylatically and Piperacillin with Tazobactam for severe established infections. The choice of antibiotics is based on the clinician’s discretion. Since the study setting is in a developing country the prophylactic use of antibiotics may be justified weighing the concerns of secondary infections. © 2015, Journal of Clinical and Diagnostic Research. All Rights Reserved.

Philip S.,Government TD Medical College | Isaakidis P.,Medecins Sans Frontieres | Sagili K.D.,International Union Against Tuberculosis and Lung Disease | Meharunnisa A.,Government TD Medical College | And 2 more authors.
PLoS ONE | Year: 2015

Background: Despite being a recognized standard of tuberculosis (TB) care internationally, mandatory TB case notification brings forth challenges from the private sector. Only three TB cases were notified in 2013 by private practitioners compared to 2000 TB cases notified yearly from the public sector in Alappuzha district. The study objective was to explore the knowledge, opinion and barriers regarding TB Notification among private practitioners offering TB services in Alappuzha, Kerala state, India. Methods & Findings: This was a mixed-methods study with quantitative (survey) and qualitative components conducted between December 2013 and July 2014. The survey, using a structured questionnaire, among 169 private practitioners revealed that 88% were aware of mandatory notification. All patient-related details requested in the notification form (except government-issued identification number) were perceived to be important and easy to provide by more than 80% of practitioners. While more than 95% felt that notification should be mandatory, punitive action in case of failure to notify was considered unnecessary by almost two third. General practitioners (98%) were more likely to be aware of notification than specialists (84%). (P<0.01). Qualitative purposive personal interviews (n=34) were carried out among private practitioners and public health providers. On thematic framework analysis of the responses, barriers to TB notification were grouped into three themes: 'private provider misconceptions about notification', 'patient confidentiality, and stigma and discrimination 'and 'lack of cohesion and coordination between public and private sector'. Private practitioners did not consider it necessary to notify TB cases treated with daily regimen. Conclusion: Communication strategies like training, timely dissemination of information of policy changes and one-to-one dialogue with private practitioners to dispel misconceptions may enhance TB notification. Trust building strategies like providing feedback about referred cases from private sector, health personnel visit or a liaison private doctor may ensure compliance to public health activities. © 2015 Philip et al.

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