Background: The cornerstone of management of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS) infection is highly active antiretroviral therapy (HAART). However, antiretroviral drugs are highly toxic and are associated with various adverse drug reactions (ADRs). Therefore, many patients require the withdrawal of the drug or even discontinue the treatment resulting in the treatment failure. Aims and Objectives: To study the demographic details and type of ADRs in patients receiving ART and to do causality, severity, and preventability assessment of the spontaneously reported ADRs. Materials and Methods: This was a retrospective cross-sectional observational study conducted for 18 months from January 2015 to June 2016 in Rajendra Institute of Medical Sciences, Ranchi. Spontaneously reported ADR data were evaluated for the patient demography, type of ADRs, drugs/regimes responsible, and body system affected. ADRs were assessed for their causality, severity, and preventability as per the standard scales. Results: Out of 356 patients given ART 197 ADR reports received which showed slight male predominance. 86.80% cases fell in 25-54 years age group with a mean age of 38.38 ± 10.74 years. The majority were neuropsychiatric (29.44%) and gastrointestinal-hepatobiliary (24.87%) followed by hematologic, dermatologic, and metabolic ADRs. Regimen containing tenofovir, lamivudine, and efavirenz were responsible for maximum number of ADRs (49.23%) followed by zidovudine, lamivudine, nevirapine (23.85%). 88.85% of ADRs were possible, 9.14% probable, and 2.03% certain according to the World health organization-Upsala monitoring centre causality assessment. 67.51% ADRs were mild followed by 29.44% moderate and 3.04% severe. 21.82% ADRs were definitely preventable, 37.06% probably preventable, and 41.12% not preventable. Conclusion: Although HAART is effective in decreasing AIDS-related deaths, it is associated with a number of ADRs. To maintain the patient compliance judicious use of ART and continuous monitoring of ADRs and their effective treatment prevention is advocated.

Background: Urinary tract infection (UTI) is one of the common infections encountered by the clinicians. Though a good number of antimicrobial agents are available, still UTIs have become difficult to treat due to development of resistance by the uropathogens. So, regional data regarding the common uropathogens and their sensitivity pattern is required to guide the clinicians to start empirical therapy while managing UTIs. The purpose of the study was to identify different species of microorganisms, along with their antimicrobial susceptibility pattern, causing urinary tract infection in outpatient and indoor patients at RIMS, Ranchi, Jharkhand.Methods: Observational study was conducted using urine culture and sensitivity reports collected retrospectively from records maintained in the department of Microbiology over a period from July 2016 to Feb 2017 in tertiary care hospital.Results: UTI was more common in females (57.74%) than in males (42.26%). Among the uropathogens isolated Escherichia coli (37.41%) was found to be the predominant organism followed by Klebsiella species (32.79%), Pseudomonas species (25.86%), and gram-positive bacteria Staphylococcus aureus accounted (3.92%) of total cases. The most common isolates were E. coli showed high sensitivity to amikacin (79.24%), followed by levofloxacin (77.21%) and gentamycin (62.26%). It was found to be resistant to norfloxacin (86%), nalidixic acid (86.76%) and cefotaxime (69.88%).Conclusions: Though various microorganisms are responsible for UTI. Escherichia coli species is the most common organism. Antimicrobial resistance has already emerged against many antibiotics, making empirical treatment of these infections challenging.

BackgroundMany epidemiological studies have established the relationship between hypertension and dyslipidemia. Calcium channel blockers (CCBs) are one of the first-line drugs for newly diagnosed patients with essential hypertension. Cilnidipine as a newer CCB acting by blocking both L- and N-type calcium channels possesses additional beneficial effects apart from lowering blood pressure (BP). The aim of this study was to evaluate the effectiveness of cilnidipine in patients with essential hypertension with borderline dyslipidemia and its effects on lipid profile.MethodsOut of 45 enrolled patients, who fulfilled the inclusion criteria, only 37 completed the study. Cilnidipine was started at 10 mg/day, and then adjusted to 5 - 20 mg/day to achieve the target blood pressure.ResultsAfter 12 weeks of study, patients showed significant reduction in systolic blood pressure, diastolic blood pressure, mean BP, heart rate and serum triglyceride level from baseline values (P < 0.00).ConclusionIn clinical setting where both hypertension and hypertriglyceridemia exist, cilnidipine can be a promising drug of choice.

BackgroundThe relation between hypertension and hyperuricemia has been established by epidemiological studies. Calcium channel blockers are one of the first-line drugs for newly diagnosed patients with essential hypertension. Cilnidipine is a new calcium channel blocker acting by blocking both L- and N-type calcium channels. The aim of this study was to compare the effectiveness of amlodipine and cilnidipine in patients with essential hypertension and their effects on heart rate and serum uric acid levels.MethodsOut of 100 enrolled patients, 92 completed the study. They were randomly assigned to amlodipine (N = 47) and cilnidipine (N = 45) groups. Cilnidipine was started at 10 mg/day and then adjusted to 5 - 20 mg/day, and amlodipine was started at 5 mg/day and then adjusted to 2.5 - 10 mg/day.ResultsAfter 24 weeks of study, patients in cilnidipine groups showed significant reduction in heart rate and serum uric acid levels from baseline (P = 0.00).ConclusionIn clinical setting where both hypertension and hyperuricemia exist, cilnidipine can be a promising drug of choice.

Background: This was a prospective observational study done to observe the effects of telmisartan on cognitive function in hypertensive dementia patients.Methods: The study included new diagnosed hypertensive and normotensive dementia patients. Patients comprised of four groups; hypertensive dementia patients taking telmisartan (group 1), hypertensive dementia patients taking donepezil and telmisartan (group 2), normotensive dementia patients taking donepezil (group 3) and normotensive dementia patients taking drugs which does not affect memory (group 4).Cognitive function of four groups were compared to each other at 4, 8 and 12 weeks.Results: In group 1, 2 and 3 mini-mental state examination (MMSE) scores has increased by 1.69, 16.81, and 13.28 percent and in group 4 there is decrease in MMSE score by 6.03 percent in 12 weeks.Conclusions: In this study we can conclude that telmisartan has dementia preventing propensity which is better than placebo but not as good as donepezil.