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Kandel A, Pant P, Todi S, KC S, Pandey S. Effect of exercise and pharmacotherapy on non-alcoholic fatty liver disease. SAGE Open Med 2024; 12:20503121241227090. [PMID: 38283643 PMCID: PMC10812096 DOI: 10.1177/20503121241227090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Objectives Nonalcoholic fatty liver disease is one of the emerging liver diseases affecting 20%-30% of the population creating a burden on public health worldwide and has been associated with the causation of multiple diseases. Besides exercise, several drugs are being used in patients based on clinical evidence especially vitamin E, a potent antioxidant to reduce the oxidative stress responsible for the development and progression of nonalcoholic fatty liver disease. This study aims at evaluating the effect of exercise and pharmacotherapy on nonalcoholic fatty liver disease. Design A prospective follow-up study with purposive sampling was done at a liver clinic for 3 months. Baseline characteristics such as anthropometric measurements and biochemical parameters were recorded and compared after 3 months to determine the effect of therapy. Descriptive analysis using a parametric test was used to assess the change in biochemical parameters and a non-parametric test was applied to find out the association between non-pharmacological and pharmacological approaches. Results Out of 177 patients, 67.2 % were male and 32.8% were female with the mean age ±SD of 46.8 ± 12.06 years. Mean ± SD weight and body mass index of the patients were changed from 74.88 ± 11.61 kg to 72.37 ± 11.61 kg and from 28.41 ± 4.02 kg/m2 to 27.31 ± 4.58 kg/m2 respectively which was found to be statistically significant. There was a significant change in all the biochemical parameters with the p-value < 0.05 through both non-pharmacological and pharmacological approaches. Conclusion Nonalcoholic fatty liver disease management through exercise and pharmacotherapy shows significant improvement in biochemical parameters indicating that alone or in combination with both approaches play an effective role in treating nonalcoholic fatty liver disease.
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Affiliation(s)
- Amrita Kandel
- Pharmacy Program, CiST College, New Baneshwor, Kathmandu, Nepal
| | - Poonam Pant
- Pharmacy Program, CiST College, New Baneshwor, Kathmandu, Nepal
| | - Sushila Todi
- Obstetrics and Gynaecology Departments, Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Sudhamshu KC
- Hepatology Departments, NAMS, Bir Hospital, Kathmandu, Nepal
| | - Sudip Pandey
- Madan Bhandari University of Science and Technology, Lalitpur, Nepal
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Lama S, Todi S, Shrestha R, Acharya S. Peripartum Hysterectomy among Patients Admitted to the Department of Obstetrics and Gynaecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2023; 61:400-403. [PMID: 37203891 PMCID: PMC10896438 DOI: 10.31729/jnma.8162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
Introduction Emergency peripartum hysterectomy is a life-saving procedure performed as an emergency procedure to control torrential bleeding and it is associated with significant maternal morbidity and mortality. There are only a few studies regarding this topic so this study guides us to monitor the trend and start appropriate policies to reduce unnecessary caesarean deliveries. The aim of this study was to find out the prevalence of peripartum hysterectomy among patients admitted to the Department of Obstetrics and Gynaecology in a tertiary care centre. Methods A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of the tertiary care centre. Data from 1 January 2015 to 31 December 2022 were collected between 25 January 2023 and 28 February 2023 from the hospital records. Ethical approval was obtained from the Institutional Review Committee of the same institute (Reference number: 2301241700). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results Among 54,045 deliveries, peripartum hysterectomy was seen in 40 (0.074%) (0.05-0.10, 95% Confidence Interval). The major indication of emergency peripartum hysterectomy was abnormal placentation (placenta accreta spectrum) which was 25 (62.50%) followed by uterine atony in 13 (32.50%) of patients and uterine rupture in 2 (5%). Conclusions The prevalence of peripartum hysterectomy was lower than in other studies done in similar settings. The indication for Emergency peripartum hysterectomy has changed in recent years from uterine atonicity to the morbidly adherent placenta which is due to a rise in the caesarean section rate. Keywords caesarean section; hysterectomy; placenta accreta.
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Affiliation(s)
- Sushma Lama
- Department of Obstetrics and Gynaecology, Patan Academy Of Health Sciences, Lagankhel, Kathmandu, Nepal
| | - Sushila Todi
- Department of Obstetrics and Gynaecology, Patan Academy Of Health Sciences, Lagankhel, Kathmandu, Nepal
| | - Reena Shrestha
- Department of Obstetrics and Gynaecology, Patan Academy Of Health Sciences, Lagankhel, Kathmandu, Nepal
| | - Swikrity Acharya
- Department of Obstetrics and Gynaecology, Patan Academy Of Health Sciences, Lagankhel, Kathmandu, Nepal
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Ramakrishnan N, Baronia AK, Divatia JV, Bhagwati A, Chawla R, Iyer S, Jani CK, Joad S, Kamat V, Kapadia F, Mehta Y, Myatra SN, Nagarkar S, Nayyar V, Padhy S, Rajagopalan R, Ray B, Sahu S, Sampath S, Todi S. Critical care delivery in intensive care units in India: Defining the functions, roles and responsibilities of a consultant intensivist. Indian J Crit Care Med 2020. [DOI: 10.5005/ijccm-17-s1-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Bhagwati AM, Singhi S, Ramachandran B, Ramakrishnan N, Gopalakrishnan R, Kamat VN, Nagaraja P, Prayag S, Todi S. Guidelines for the Prevention of Infections Associated with the Use of Vascular Catheters in Indian Intensive Care Units. Indian J Crit Care Med 2013. [DOI: 10.5005/ijccm-17-5-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ramakrishnan N, Baronia AK, Divatia JV, Bhagwati A, Chawla R, Iyer S, Jani CK, Joad S, Kamat V, Kapadia F, Mehta Y, Myatra SN, Nagarkar S, Nayyar V, Padhy S, Rajagopalan R, Ray B, Sahu S, Sampath S, Todi S. Critical care delivery in intensive care units in India: Defining the functions, roles and responsibilities of a consultant intensivist. Indian J Crit Care Med 2013. [DOI: 10.5005/ijccm-17-5-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ghafur A, Mathai D, Muruganathan A, Jayalal JA, Kant R, Chaudhary D, Prabhash K, Abraham OC, Gopalakrishnan R, Ramasubramanian V, Shah SN, Pardeshi R, Huilgol A, Kapil A, Gill JPS, Singh S, Rissam HS, Todi S, Hegde BM, Parikh P. The Chennai declaration: A roadmap to tackle the challenge of antimicrobial resistance. Indian J Cancer 2013; 50:71-3. [DOI: 10.4103/0019-509x.104065] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ray S, Pramanik J, Bhattacharyya M, Todi S. Prospective observational evaluation of incidences and implications of drug-drug interactions induced adverse drug reactions in critically ill patients. Indian J Pharm Sci 2011; 72:787-92. [PMID: 21969755 PMCID: PMC3178984 DOI: 10.4103/0250-474x.84597] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 08/13/2010] [Accepted: 11/08/2010] [Indexed: 12/04/2022] Open
Abstract
The primary aim of this study is to identify and analyze the importance of adverse drug reaction due to drug-drug interaction as a contributing factor towards drug safety. Patients more than 18 years of age admitted in multidisciplinary intensive care unit of a tertiary care hospital were included in this study. Patients who stayed less than 48 h and patients in whom all treatment modalities have been withdrawn and were on comfort measures only (no drugs were prescribed), were excluded. All the drugs that were given during intensive care unit stay were checked for presence of potential interactions which led to adverse drug reaction. Drug-drug interactions that were detected clinically or through investigations were recorded and also any therapeutic actions taken for drug-drug interactions were noted. From June 2006 to April 2007, 400 patients-prescriptions were analyzed. Adverse drug reactions due to drug-drug interactions were identified in 64% patients. Among those patients 38.67% had a single drug-drug interaction. Potential drug-drug interactions were 602. Clinically significant drug-drug interactions among the potential were 208 (34.55%). Clinically relevant drug-drug interactions were 103 (49.52% of 208 episodes). The adverse drug reactions due to drug-drug interactions in our sample were managed either by substituting another drug (50.48% of 103 episodes) or by adjusting the dose (1% of 103 episodes) or by omitting the drug (48.54% of 103 episodes). Among the 208 observed drug-drug interactions induced adverse drug reactions 21.63% was severe drug-drug interactions induced adverse drug reactions, 23.08% was moderate drug-drug interactions induced adverse drug reactions and 55.29% was minor drug-drug interactions induced adverse drug reactions. The interactions which were life threatening and/ or require medical intervention to minimize or prevent serious adverse effects were considered as severe drug-drug interactions and those interaction which resulted in an exacerbation of the patient's condition and/ or require an alteration in therapy were considered as moderate drug-drug interactions. The interactions which were limited clinical effects and manifestations may include an increase in the frequency or severity of side effects but generally would not require a major alteration in therapy were classified as minor drug-drug interactions. The correlation coefficient was 0.86 between the number of drugs given to the patient & number of average potential adverse drug reactions found among the patients. Increase in number of prescribed drug significantly (one way) increases number of potential adverse drug reaction due to drug-drug interaction (p<0.0001). Critically ill patients are more susceptible to drug-drug interactions due to the administration of multiple drugs and complex drug combinations. Several drug-drug interactions were clinically irrelevant.
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Affiliation(s)
- S Ray
- Department of Pharmaceutical Technology, Jadavpur University, Raja S. C. Mallick Road, Kolkata-700 032, India
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Todi S, Bhattacharyya M. Glucose variability and ICU outcome. Crit Care 2011. [PMCID: PMC3068331 DOI: 10.1186/cc9822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Bhattacharyya M, Todi S. Comparison of glucose variability measures. Crit Care 2011. [PMCID: PMC3068336 DOI: 10.1186/cc9827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bhakta A, Bhattacharyya M, Todi S. A creep in the vancomycin minimum inhibitory concentration for Staphylococcus aureus in a tertiary care hospital in India. Crit Care 2011. [PMCID: PMC3066906 DOI: 10.1186/cc9652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Basu S, Chaudhuri S, Bhattacharyya M, Chatterjee TK, Todi S, Majumdar A. Microalbuminuria: An inexpensive, non invasive bedside tool to predict outcome in critically ill patients. Indian J Clin Biochem 2010; 25:146-52. [PMID: 23105901 DOI: 10.1007/s12291-010-0027-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study was conducted to evaluate whether microalbuminuria on admission and after 24 hrs of admission to intensive care unit (ICU) predicts outcome as well as the Acute Physiology and Chronic Health Evaluation (APACHE) II severity illness score, the current accepted method of doing so. The study was carried out in a 20 bed mixed medical-surgical ICU of a tertiary care hospital. Of 525 consecutive adult patients with ICU stay of more than 24 hrs, 238 were included for the study. Patients with pregnancy, menstruation, anuria, macroscopic hematuria, urinary tract infection, marked proteinuria due to renal and post-renal structural diseases, were excluded. Spot urine samples were collected on admission to ICU and 24 hrs thereafter. Urine albumincreatinine ratio (ACR) was measured on ICU admission (ACR1) and after 24 hrs (ACR2) and expressed in mg/g. Patient demographics were noted on admission. For disease severity scoring, APACHE II scores were calculated. Each patient was followed up throughout their ICU stay for a maximum of 28 days and the following outcome data were obtained: ICU length of stay and ICU mortality. Of the 238 patients, 196 survived while 42 patients died in the ICU. Non-survivors had a significantly higher median ACR2 [162.7 mg/g (IQR 69.5-344.3)] in comparison to the survivors who had a median ACR2 = 54.4 mg/g (IQR 19.0-129.1) (P< 0.0001). The median ACR1 [161.0 mg/g (IQR 29.0-369.3)] of non-survivors was higher than the median ACR1 [80.4 mg/g (IQR 35.1-167.6)] of survivors but failed to reach statistical significance (P= 0.0948). In a receiver operating characteristic curve (ROC) analysis, ACR2 emerged as the best indicator of mortality [(area under curve (AUC) of ACR2 = 0.71 > AUC (ACR1) =0.58 > AUC (ΔACR) =0.55] similar to the currently used APACHE II scores (AUC = 0.78) (P=0.3). At a cutoff of 101 mg/g, ACR2 had a sensitivity of 69%, specificity of 67%, positive predictive value of 31% and a negative predictive value of 91% for predicting mortality in the critically ill patients. Absence of significant microalbuminuria at 24 hrs of ICU admission may help to predict survival in the ICU.
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Affiliation(s)
- Surupa Basu
- Department of Laboratory Medicine, AMRI Hospitals, Besides Dhakuria Bridge, Kolkata, 700 029 India
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Basu S, Bhattacharya M, Chatterjee T, Todi S, Majumdar A. Significant microalbuminuria, on admission to the ICU, may indicate AKI in patients with sepsis. Crit Care 2010. [PMCID: PMC2934415 DOI: 10.1186/cc8758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Bhakta A, Bhattacharyya M, Todi S. Risk of acquiring drug-resistant (MDR) Gram-negative isolates with previous exposure to antibiotic. Crit Care 2010. [PMCID: PMC2934058 DOI: 10.1186/cc8298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Basu S, Bhattacharyya M, Chatterjee T, Todi S, Majumdar A. Urinary albumin excretion is elevated in sepsis, but does not correlate with circulating VEGF-A levels. Crit Care 2010. [PMCID: PMC2934154 DOI: 10.1186/cc8253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Bhattacharyya M, Bhakta A, Todi S. Impact of quality improvement process on healthcare-associated infection in the ICU in a tertiary care hospital in India. Crit Care 2010. [PMCID: PMC2934200 DOI: 10.1186/cc8691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sarkar C, Majumdar A, Todi S. Study of serum vancomycin levels in different modalities of hemodialysis in Indian patients. Crit Care 2010. [PMCID: PMC2933986 DOI: 10.1186/cc8764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Majumdar A, Basu S, Bhattacharya M, Kharbanda M, Sinha P, Todi S. Utilization of slow low-efficiency dialysis may help to optimize the need for continuous renal replacement therapy in Indian ICUs. Crit Care 2009. [PMCID: PMC4084157 DOI: 10.1186/cc7435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kharbanda M, Todi S, Majumdar A, Basu S. Crit Care 2006; 10:P277. [DOI: 10.1186/cc4624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ramakrishnan N, Baronia AK, Divatia JV, Bhagwati A, Chawla R, Iyer S, Jani CK, Joad S, Kamat V, Kapadia F, Mehta Y, Myatra SN, Nagarkar S, Nayyar V, Padhy S, Rajagopalan R, Ray B, Sahu S, Sampath S, Todi S. Critical care delivery in intensive care units in India: Defining the functions, roles and responsibilities of a consultant intensivist. Indian J Crit Care Med 2006. [DOI: 10.5005/ijccm-10-1-53] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
OBJECTIVE To validate a portable, inexpensive, real-time, B-mode ultrasound device compared with duplex ultrasound in the detection of proximal lower extremity deep vein thrombosis in hospitalized patients clinically suspected of having deep vein thrombosis. DESIGN Prospective cohort study. SETTING Tertiary care community teaching hospital. PATIENTS Medical-surgical hospitalized patients undergoing duplex ultrasonography for clinically suspected lower extremity deep vein thrombosis. INTERVENTIONS Hospitalized patients who underwent duplex ultrasound examinations were enrolled in the study. Blinded from the duplex ultrasound results, the investigators utilized the study ultrasound device to perform compression ultrasonography of the common femoral, superficial femoral, and popliteal veins within 48 h of the duplex examinations. The results of the study ultrasound device were recorded as normal (compressible) or abnormal (noncompressible). RESULTS Of the 198 lower limbs evaluated, duplex ultrasonography documented 34 proximal lower extremity deep vein thrombi. The study ultrasound device detected 32 of the 34 proximal thrombi detected by duplex ultrasonography. One false-positive result of an examination occurred with the study ultrasound device. Compared with duplex ultrasonography, the study ultrasound device had a sensitivity of 94%, specificity of 99%, positive predictive value of 97%, and negative predictive value of 98%. CONCLUSIONS The results of this investigation document that the study ultrasound device has an acceptable sensitivity, specificity, and diagnostic accuracy for clinical use in detection of proximal lower extremity deep vein thrombosis. Further evaluation and validation of this ultrasound device are warranted.
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Affiliation(s)
- S J Trottier
- Department of Critical Care Medicine, St. John's Mercy Medical Center/St. Louis University, MO, USA
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Maity AK, Chatterjee SS, Todi S, Kar S, Chakrabarty M, Ganguly K, Kar CC. Profile of renal artery stenosis with a reference to aortoarteritis. Indian Heart J 1986; 38:451-6. [PMID: 2896162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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