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Pawar, S.
- Role of Hypothyroidism in Onset and Survival in Cancers: Review of Literature
Authors
1 Department of Pharmacology, 2nd Floor, College Building, Lokmanya Tilak Memorial Medical College, Dr B R Ambedkar Road, Sion, Mumbai - 400022, IN
2 Department of Pharmacology, Lokmanya Tilak Memorial Medical College & General Hospital, Sion, Mumbai - 400022, IN
Source
The Indian Practitioner, Vol 68, No 1 (2015), Pagination: 31-35Abstract
Various experimental and clinical studies have investigated the role of thyroid hormone in normal as well as cancer cells. It has been observed that the presence of or the induction of hypothyroidism negatively influence certain types of cancers. This is seen as reduction in the occurrence of cancers, slowing of cancer growth and lesser incidence of metastasis in many cases. Few studies also observed an increase in the overall survival rate in cancer patients having incidental hypothyroidism. There are however few types of cancers which are rather negatively influenced by hypothyroidism. More studies are required to confirm the above and to investigate whether controlled induction of hypothyroidism can by any ways be used for increased survival.Keywords
Hypothyroidism, Cancer, Survival, Propylthiouracil, Animal Studies.
- Does Hemodialysis Improve Health-Related Quality of Life in Chronic Kidney Disease? A Tertiary Care Centre Experience
Authors
1 Department of Medicine and Division of Nephrology, Pt. B.D. Sharma University of Health Sciences, Rohtak-124001 (Haryana), IN
Source
The Indian Practitioner, Vol 70, No 3 (2017), Pagination: 23-27Abstract
Introduction: Advances in dialysis procedures have improved treatment and prolonged lives of chronic kidney disease (CKD) patients. However, improving survival via dialysis is not enough. Assessment of health-related quality of life (HRQoL) in CKD patients has evolved with treatment advances so that the expectation of patient outcomes has grown from simple survival to achieving a sense of well-being.
Objective: To evaluate HRQoL scores with either Hemodialysis (HD) or non-dialysis-dependent advanced CKD.
Methods: Adults CKD patients with eGFR less than 30 ml/min/1.73 m2 were randomly selected and divided into two groups; group A and B. Group A consisted of patients on medical management without any renal replacement therapy and group B with patients undergoing thrice-weekly in-center HD for more than three months. All patients were assessed for HRQoL through the SF-36 questionnaire. Patients having psychiatric illness or cognitive dysfunction, transplanted kidney and haemodialysis less than three months were excluded from study.
Results: HRQoL composite summary scores were severely and significantly impaired in group B patients as compared to group A. The mean PCS scores in group A and B were 34.52±5.54 and 31.08±6.83, respectively and the difference being statistically significant. The MCS scores also showed a statistically significant difference among both groups.
Conclusion: In our study low scores were registered in both the composite summary scores of HRQoL in HD group of patients as compare to non-HD group Study points that care is often suboptimal by developed world standards.
Keywords
Chronic Kidney Disease, Health-Related Quality of Life, Renal Replacement Therapy, Hemodialysis.References
- NKF: Stages of Chronic Kidney Disease. New York: National Kidney Foundation; 2000. [cited 2000];2000:[Available from: http://www.kidney.org/ professionals/kdoqi/guidelines_ckd/toc.htm.
- ISN, IFKF: World Kidney Day. Brussels: International Society of Nephrology International Federation of Kidney Foundations; 2009. Available from: www.worldkidneyday.org.
- Anand S, Bitton A, Gaziano T. The gap between estimated incidence of end-stage renal disease and use of therapy. PLoS One 2013;8:e72860.
- Yu HD, Petrini MA: The HRQoL of Chinese patients undergoing haemodialysis. J Clin Nurs 2010;19:658– 65.
- Eiser C, Jenney M. Measuring quality of life. Arch Dis Child. 2007 Apr;92(4):348-50.
- Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. J Am Soc Nephrol 2001;12(12):2797-806.
- Ware JE, Kosinski M, Keller SK. SF-36 Physical and Mental Health Sumary Scales: A User’s Manual. Boston: The Health Institute; 1994.
- Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT: The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ 1993;306(6890):1440-4.
- Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130(6):461–70.
- Finkelstein FO, Wuerth D, Finkelstein SH. Health related quality of life and the CKD patient: challenges for the nephrology community. Kidney Int. 2009;76(9):946–52.
- Soni RK, Weisbord SD, Unruh ML. Health-related quality of life outcomes in chronic kidney disease. Curr Opin Nephrol Hypertens. 2010;19(2):153–9.
- Cukor D, Cohen SD, Peterson RA, Kimmel PL. Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. Journal of the American Society of Nephrology 2007;18:3042-55.
- Kurtin PS, Davies AR, Meyers KB, DeGiacomo JM, Kantz ME. Patients-based health status measures in out-patient dialysis: early experiences in developing an outcome assessment program. Med Care 1992;30:MS136-49.
- Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life: a conceptual model of patients outcomes. JAMA1995;273:59-65.
- Khan IH, Garratt AM, Kumar A. Patient’s perception of health on renal replacement therapy: evaluation using a new instrument. Nephrol Dial Transpl 1995;10:684-9.
- Kimmel PL, Peterson RA, Wheis LK. Behavioral compliance in hemodialysis patients. J Am Soc Nephrol 1995;5:1826-34.
- Tong A, Sainsbury P, Chadban S. Patients’ experiences and perspectives of living with CKD. Am J Kidney Dis. 2009;53:689-700.
- Awuah KT, Finkelstein SH, Finkelstein FO. Quality of life of chronic kidney disease patients in developing countries. Kidney International Supplements 2013(3): 227–9.
- Krespi R, Bone M, Ahmad R, Worthington B, Salmon P. Haemodialysis patients’ beliefs about renal failure and its treatment. Patient Educ Couns. 2004;53:18996.
- Unruh ML, Hess R: Assessment of health-related quality of life among pa- tients with chronic kidney disease. Adv Chronic Kidney Dis 2007;14:345–52.
- Reuben DB, Tinetti ME: Goal-oriented patient care – an alternative health outcomes paradigm. N Engl J Med 2012;366:777–9.
- Valproate Causing Recurrent Acute Pancreatitis
Authors
1 Dept. of Medicine, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, Maharashtra, IN
2 Dept, of Medicine, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, Maharashtra, IN
Source
The Indian Practitioner, Vol 70, No 8 (2017), Pagination: 36-38Abstract
Valproic acid is used either as monotherapy or in combination with other anticonvulsants for the treatment of simple, mixed and complex partial seizures, myoclonic seizure, generalised tonic- clonic seizure, acute manic episodes in bipolar disorder, and for prophylaxis of migraine headaches. The association of sodium valproate and pancreatitis is sometimes referred to as idiosyncratic as pancreatitis can develop after 1 week to 8 years of exposure to sodium valproate. We report a case of 39 year old male known case of seizure disorder presenting with recurrent episodes of epigatrium and right hypochondrium abdominal pain associated with vomiting over a period of 4 years. After excluding other causes of pancreatitis, a diagnosis of valproate induced necrotising pancreatitis was established.Keywords
Valproic Acid, Pancreatitis.References
- Pancreatitis associated with valproic acid: a review of the literature. Chapman SA, Wacksman GP, Patterson BD. Pharmacotherapy. 2001;21:1549– 1560.
- Idiosyncratic adverse reactions to antiepileptic drugs. Zaccara G, Franciotta D, Perucca E. Epilepsia.2007;48:1223–1244.
- Gerstner T, Büsing D, Bell N. et al. Valproic acidinduced pancreatitis:16 new cases and a review of the literature. J Gastroenterol. 2007;42(1):39–48.
- Wilmink T, Frick WK. Drug induced pancreatitis. Drug safety 1996; 14: 406-423.
- Pancreatitis associated with valproic acid therapy. Batalden PB, Van Dyne BJ, Cloyd J. Pediatrics.1979;64:520–522.
- Pancreatitis due to valproic acid. Camfield PR, Bagnell P, Camfield CS, Tibbles JA. Lancet. 1979;1:1198–1199.
- Hamad AE, Fawzi ME. Valproate associated acute pancreatitis. Neurosciences. 2000;5(3):156–8.
- The role of oxygen-derived free radicals in the pathogenesis of acute pancreatitis. Sanfey H, Bulkley GB, Cameron JL. Ann Surg. 1984;200:405– 413.
- Acute pancreatitis coincident with valproate use: a critical review. Pellock JM, Wilder BJ, Deaton R, Sommerville KW. Epilepsia. 2002;43:1421–1424.
- Carnitine levels in valproic acid-treated psychiatric patients: a cross-sectional study. Moreno FA, Macey H, Schreiber B. J Clin Psychiatry. 2005;66:555–558.
- The spectrum of valproic acid-associated pancreatitis. Werlin SL, Fish DL. Pediatrics. 2006;118:1660– 1663.
- Patient Profile and Prevailing Trends of Cough Management in India: Results of the COFPRO Survey
Authors
1 Medical Affairs, Wockhardt Ltd, Mumbai, IN
2 Bharatiya Arogyanidhi Hospital, Mumbai, IN
3 Dr Rege’s Clinic, Mumbai, IN
Source
The Indian Practitioner, Vol 70, No 10 (2017), Pagination: 17-24Abstract
Objective: To find the profile and management pattern of cough in out patients visiting family physicians (general practitioners) in India.
Material and methods: The survey was done in two phases (monsoon and winter). Parameters captured included occupational exposure of infection or irritant, duration of cough, history of similar episodes, nature, intensity and frequency of cough, associated symptoms, co-morbid conditions, concomitant medications, self-medication and drugs used for treatment of cough.
Result: Of the 5115 enrolled patients (male 69%; female 31%),2404 (47%)had exposure to infection or irritants at work place. Duration of cough was five days in 3069 (60%) patients while 5064 (99%) had similar episodes in last 12 months. Nature of cough in 2916 (57%) patients was dry with no or minimal sputum. A total of 1995 (39%) patients had two to six bouts of cough per day whereas six to ten cough bouts were reported by 1739 (34%) patients. Common associated symptoms were headache 1330 (26%), hoarseness of voice 1228(24%), sore throat/throat pain 1125 (22%), nasal stuffiness 972 (19%), runny nose 921(18%), sleep disturbances 818(16%), sneezing 665 (13%), fatigue/body ache 614 (12%) and fever 614 (12%). Allergic rhinitis and asthma was present in 2506 (49%) and 512 (10%) patients respectively. History of self-medication was present in only 614 (12%) patients which included OTC/herbal cough syrups. Adverse events related to self medication included sleep pattern disturbances (excess and reduced) reported by 51% patients. Antitussives, decongestants, antibiotics and antihistamines were prescribed in 4245 (83%), 4552 (89%), 2609 (51%) and 2456 (48%) patients respectively.
Conclusion: Patients with recurrent cough may have exposure to infection or irritants at the place of job. Dry cough with up to 10 bouts per day and atleast one similar episode history is the most common type of cough presenting to family physicians (general practitioners). Majority of patients seek medical opinion within five days of starting of cough symptom and self medication rate was low. Allergic rhinitis is the most common (49%) comorbid condition with cough. Antitussives, decongestants, antibiotics and antihistamines are the common medicines used for management of cough.