Care Hospital In Puducherry Research Articles

Impact of Health Education Programs on Awareness of Glaucoma in a Tertiary Care Hospital in South India

Objective: To assess the impact of health education programs on the awareness and knowledge of glaucoma among subjects attending the Ophthalmology office in a tertiary care hospital in Puducherry. Methods: It is a cross sectional study with 1000 subjects of age >40 years attending the Ophthalmology outpatient department. A questionnaire was administered in English/Tamil to assess the awareness (heard about glaucoma) and knowledge (understanding the disease and risk factors) about glaucoma. Glaucoma awareness programs are being conducted in our hospital and in Puducherry since 2010. Results: The awareness about glaucoma was found to be 41%. Majority of the people who were aware of glaucoma had a good level of knowledge (56.8%). Conclusion: Our study concluded increase in awareness of glaucoma among the people attending the outpatient department post awareness programs. But the awareness was still less than that of cataract and diabetic retinopathy.

Pattern of Utilization of Consultation-Liaison Psychiatry Services in A Tertiary Centre in South India

Background and Objective: Consultation-Liaison Psychiatry (C-LP) services, an important aspect of every general hospital has wide variations in their pattern of services being utilized. Studies in this area are mostly conducted in northern states of India. Our study aims to see the pattern of inpatient referrals to the department of psychiatry in a tertiary hospital in South India. Material and Methods: One hundred and seventeen inpatient referrals to the Department of Psychiatry of a tertiary care hospital in Puducherry over a period of six months were included for the study. Informed consent was taken. Information about sociodemographic profiles was collected. Mini International Neuropsychiatric Interview (MINI-PLUS), a semi-structured diagnostic interview tool was administered for psychiatric diagnosis. Results: The inpatient referral rate was 1.50%. Evaluation of para-suicide was the commonest reason for referral (36.7%), followed by depressive symptoms (12.8%), alcohol related problems (12.8%), and abnormal behaviour (10.3%). Psychiatric diagnosis was found in 86% of cases referred; 41% had multiple psychiatric diagnoses. Deliberate Self-harm (DSH) was present in 28% and depressive disorder in 22% of cases. Gastro-intestinal disorders (12%), infectious disorders (11%) and cardiovascular disorders (9%) were the commonest medical diagnoses in the population. Department of Medicine had the highest referral rate; however referrals from most departments were very low. Conclusion: The study depicts a low referral rate which can be attributed to the lack of knowledge and high rate of stigma of psychiatric disorders. Thus, there is an urgent need to strengthen the existing C-LP services and screen for psychiatric disorders in non-psychiatric inpatients.

Antibiotics prescription pattern and compliance for common childhood illnesses – an observational study

Introduction: Antibiotics are generally overused in children. Frequent inappropriate use of antibiotics and poor compliance contributes to antibiotic resistance. An observational study was undertaken to determine the pattern of antibiotic use and compliance for common ailments in children attending a tertiary care hospital in Puducherry, South India. Methods: Data was obtained from 197 consecutive children who had visited a health care provider during the previous two weeks for any ailment, in a pretested semi structured questionnaire. Data was entered on MS Excel spreadsheet and analysed using Stata14.0 (Stata Corp, College Station, Tx). Chi square test with Fisher’s modification and logistic regression models were used in the analysis. Results: Acute respiratory infections were the most common infections in all age groups followed by diarrheal disorders in infants and fever in older children. Proportion of illnesses which received antibiotics was 75% for respiratory illnesses, 78% for fever, 50% for diarrheal disorders and 64% for other infections, there being no statistically significant difference between them. Out of 143 children who were prescribed antibiotics, 127 (89%) gave the medicines as prescribed. However, only 53 (37%) completed the full course of antibiotics. Compliance with treatment was not associated with age or the type of illness. Most of the parents (73%) discontinued antibiotics because of worsening of symptoms. Adverse reaction to antibiotics was seen in 32 (22%) children. Conclusion: Overuse of antibiotics for common ailments and poor compliance with treatment were perhaps important contributory causes for development of antimicrobial resistance in this region.

Prescription pattern of patients admitted in the intensive care unit of a tertiary care hospital in Puducherry, India: a cross sectional study

Background: Patients with varied demographic characteristics, admission criteria and heterogeneous group are admitted to medical Intensive Care Unit (ICU) and are usually associated with co-morbid illnesses. Instituting rational pharmacotherapy is the need of the hour for saving the life of critically-ill patients while irrational drug use may be life threatening. Drug use patterns and prescribing behaviour are the essential tools to measure drug use in health care facilities.Methods: A record based, cross-sectional, observational study was done at medical ICU, IGMC and RI, Puducherry after obtaining IEC approval. Systemic random sampling was followed and data was collected for a period of one year. Data were analysed based on demographic characteristics, prescribing pattern and WHO drug use indicators.Results: The data of 151 patients were analysed. Mean age of the patients admitted in ICU was 52.9±17.7 years. Percentage of male patients (57.6) admitted in ICU were more when compared to female patients (42.4). Infective etiology was the most common factor for ICU admission followed by cardiac disorders. Diabetes mellitus and hypertension were the most common co-morbidities. The average length of stay in ICU was 4.11±2.99 days. Duration of stay in ICU ranged from 1-5 days (78.8% patients) to 15-20 days (0.1% patients). On an average 10.6±4.3 drugs were prescribed for each patient. Percentage of drugs prescribed by generic name was 45.8%. Majority of the drugs (87.4%) were from essential medicine list. Antibiotics in the prescription was 13.8% and 44.4% of drugs were administered in parenteral route. The prescription was complete in 145 case sheets (96%). Majority of the patients (68.9%) were discharged with improvement in the condition for which they were admitted.Conclusions: This drug utilization study has highlighted the strengths and shortcomings of the prescription pattern of patients who were admitted in the critical care setup. The information derived from this research work will be transmitted to the stakeholders for implementing the modifications wherever applicable for the betterment of the patient and the community.

Cross sectional study on knowledge, attitude and practice regarding dengue among adult population visiting a tertiary care hospital in Puducherry, India

Background: Dengue is one of the world’s emerging and rapidly spreading pandemic disease of public health importance. High rainfall and low temperatures are associated with increased number of dengue cases.Methods: A hospital based cross sectional study was conducted between 15th August 2013 and 15th October 2013 with a sample of 200 in a tertiary care multi-speciality hospital in Puducherry using pre-designed and pre-tested questionnaire. The study protocol was approved by ICMR and Institutional (PIMS) Ethical Committee. Participants were included in the study based on the following criteria: (1) More than 20 years of age. (2) Permanent resident of Pondicherry.Results: Out of the 200 participants 68% were males and 32% were females. Most of them (64%) had gone to schools, while 9.5% were illiterates. Of the 200 participants, 180 (90%) knew that mosquito is the vector for Dengue. 162 (81%) of participants felt hospitalisation is necessary for dengue management. 80% of participants mentioned use of ceiling fan as a predominantly used preventive measure against mosquito bite, whereas 43% of them use mosquito coils to avoid mosquito bites. Majority of the respondents (66%) spend less than Rs.100 ($ 1.47) in a month for various mosquito preventive measures.Conclusions: The knowledge about dengue was good, although more awareness needs to be created to identify the clinical signs of dengue. The overall attitude and practices of the participants towards dengue care, prevention and control is good.

"Genotypes and Markers of Hepatitis B and Antibodies to Hepatitis C virus in Patients with Chronic Liver Disease in a Tertiary Care Hospital in Puducherry"

"Genotypes and Markers of Hepatitis B and Antibodies to Hepatitis C virus in Patients with Chronic Liver Disease in a Tertiary Care Hospital in Puducherry"

Profile of Young Suicide Attempt Survivors in a Tertiary Care Hospital in Puducherry.

Context:Puducherry has the highest suicide prevalence rate in India by 2014, predominantly among the 14–30 years age group.Aims:The aim of the present study is to study the characteristics of adolescent and youth suicide attempters in Puducherry and measure the suicide intent.Settings and Design:An observational study of 6 months duration was conducted in the Department of Psychiatry, at Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Materials and Methods:Modified version of World Health Organizations SUicide PREvention Multisite Intervention Study on Suicidal questionnaire was used to collect sociodemographic data and Beck's suicide intent scale was used to measure the suicide intent scores. International Classification of Diseases-10 was used for diagnosis.Statistical Analysis:Statistical Package for the Social Sciences version 13 was used for descriptive analysis and correlation statistics. P value was set as <0.05.Results:Of 56 eligible participants, 40 formed the sample, their mean age was 18. 13 (±2.50), more females (1.1:1), rural, literate, lower socioeconomic status (67.5%), mostly single (90%), living in nuclear (95%), and Hindu (87.5%). One hundred percent had psychosocial stressors before suicide attempt. Acute stress disorder/adjustment disorder was the most common diagnosis. Emotionally unstable and anankastic personality traits were seen in 12%. Pesticide ingestion (45%) was the most common suicide method. Sixty percent attempted suicide within <30 min of suicidal contemplation. Statistical associations were found between the alleged purpose, seriousness, attitude toward living/dying, conception about medical rescuability, and the overall suicide intent.Conclusions:Adolescent and youth suicide attempts occur due to psychosocial stressors rather than due to the past or on-going mental health disorders with above personality traits suggest poor coping skills and resilience taken to deal with stressful situations by younger people.

Cardiovascular Disease Risk Profiling Among First Degree Relatives of Coronary Artery Disease Patients Admitted in Cardiology Ward of JIPMER, Puducherry

Background: Non-communicable diseases constitute about 68% of global death annually. Among NCD deaths, cardiovascular diseases (CVD) ranks first with a share of 46.2% amounting to 17.5 million deaths. First degree relatives of patients with coronary heart disease have a higher risk of getting cardiovascular events due to interplay between genetic as well as environmental factors. The aim of this research WAS to assess the prevalence of Cardiovascular Disease (CVD) risk factors and to estimate the cardiovascular risk among first degree relatives of CAD patients. Methodology: A cross-sectional study was performed in first degree relatives of coronary artery disease patients in cardiology ward of JIPMER a tertiary care hospital in Puducherry. Overall 218 first degree relatives aged ≥18 were involved in study. The desired information was obtained using a pre-tested questionnaire and participants were also subjected to anthropometric measurements and laboratory investigations. WHO/ISH risk prediction charts for the South-East Asian region was used to assess the cardiovascular risk among the study participants according to age, gender, blood pressure, smoking status, and presence or absence of diabetes mellitus. Results: The study covered 218 adults aged above 18 years. The mean age of the subjects was 41 (± 9) years and 56% subjects were men. Around 10% of the participants had more than 10% risk for the occurrence of cardiovascular events by using WHO/ISH risk prediction charts. In addition, CVD risk factors like physical inactivity, smoking, alcohol abuse, obesity, hypertension, diabetes abnormal lipid profile were found in 22.5%, 19.2%, 16.1%, 12.4%, 33%, 29% and 13.8% study participants, respectively. Conclusion: This cross-sectional study indicates that there is a high burden of CVD risk in the first degree relatives of coronary artery disease patients as assessed by WHO/ISH risk prediction charts. Opportunistic screening programs and appropriate risk stratification based management needs to be initiated for the first degree relatives of CVD patients. Key words: Cardiovascular Disease, First degree relative, Prevalence, Cardiovascular risk prediction, CAD patients.

High incidence of plasmid-mediated quinolone resistance genes among ciprofloxacin-resistant clinical isolates of Enterobacteriaceae at a tertiary care hospital in Puducherry, India.

Background. Plasmid-mediated quinolone resistance (PMQR) has received considerable attention recently. Data analysis in Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) revealed 75% of the Enterobacteriaceae isolates to be ciprofloxacin-resistant in 2012. Few reports regarding the prevalence of PMQR are available from India. Hence, the present study was carried out to ascertain the prevalence of PMQR genes among clinical isolates of ciprofloxacin-resistant Enterobacteriaceae in JIPMER.Methods. The study included 642 ciprofloxacin-resistant clinical Enterobacteriaceae isolates. JIPMER hospital’s annual consumption data for fluoroquinolones were retrieved from the Department of Pharmacy. The test isolates were screened for the presence of qnr A, B, D, S and aac(6′)-Ib-cr genes. PMQR-positive isolates alone were tested for the presence of class I (intI1) and class II (intI2) integrons. Randomly selected PCR amplicons were sequenced and analysed using MEGA software. A total of 30 PMQR strains chosen at random were assessed for the transferability of the PMQR genes.Results. A majority of the strains exhibited high MIC values with 106 strains exhibiting MIC values >256 µg/mL. The aac(6′)-Ib-cr gene had the highest prevalence at 64% (414) while, qnrB and qnrS genes were present in 15% (97) and 10% (64) of the isolates respectively. None of the strains were positive for qnrA and qnrD. All PMQR-positive isolates were screened for class I (intI1) and class II (intI2) integrons. Class I integron was found to be predominant among the test isolates with a few of them carrying both the classes of integrons. Transferability of PMQR genes to transconjugants was identified.Conclusion. The incidence of PMQR genes in the tertiary-care setup of the JIPMER hospital was found to be high which could be probably due to the increased prescription of fluoroquinolones. Thus, there is a need for rational usage of fluoroquinolones.

Is Ultrasound a Useful Tool to Predict Severe Dengue Infection?

To study the role of ultrasound in children with dengue fever and determine its role in predicting the severity of the disease. This was a retrospective hospital based study conducted from 1(st) August 2012 to January 31(st) 2015 at a tertiary care hospital in Puducherry. Two hundred and fifty four children were admitted with dengue fever and among them non-severe dengue and severe dengue were seen in 62.6 % and 37.4% respectively. Mean age of presentation was 7.0 (3.3) years. M: F ratio was 1.2:1 Ultrasound was performed on all children with dengue fever during the critical period of illness as an early sign of plasma leakage and at the time of discharge. The diagnosis was confirmed by NS1 antigen and dengue serology. Ultrasonography showed positive findings in 156 cases (61.4%) during the critical period of illness. Ultrasound findings were analyzed using logistic regression among severe and non-severe dengue and P value of <0.05 was taken as significant. The common ultrasound findings that were significantly associated with severe dengue infection on univariate analysis were gall bladder wall thickening, ascites, pleural effusion, pericardial effusion, pericholecystic fluid, hepatomegaly, splenomegaly and mesenteric adenopathy. On multivariate analysis, gall bladder thickening and hepatomegaly were significantly associated with severe dengue infection. Gall bladder wall thickening (GBWT) with honeycombing pattern was the most specific finding in severe dengue infection in the study and significantly associated with severe thrombocytopenia (Platelet count <50,000/mm(3)). The clinical improvement coincided with resolving of the ultrasound findings at the time of discharge. Ultrasound can be used as an early predictor as well as an important prognostic sign for severe dengue infection especially during an epidemic.

Plasma Fibrinogen in Chronic Obstructive Pulmonary Disease – A Cross Sectional Study Conducted in a Tertiary Care Hospital in Puducherry, India

Background: Chronic Obstructive Pulmonary Disease (COPD) is a systemic disorder rather than a respiratory disease. A significant complication that COPD can lead to a hypercoagulable state, which can lead to life-threatening diseases like Ischemic heart disease, deep vein thrombosis and Pulmonary embolism. Therefore, Fibrinogen is a useful biomarker to predict the risk of such hypercoagulable state in COPD patients. Objectives: The study was aimed to measure the fibrinogen levels in COPD patients, to correlate the fibrinogen levels with severity of airway obstruction based on spirometry and also to compare Original Research Article

A Study on Polypharmacy and Potential Drug-Drug Interactions among Elderly Patients Admitted in Department of Medicine of a Tertiary Care Hospital in Puducherry.

The proportion of elderly population has been constantly increasing over last few years. Polypharmacy is unavoidable in the elderly as they often suffer from multiple co-morbidities. Potential drug-drug interaction due to polypharmacy and potential inappropriate medication among the elderly must be carefully assessed. To find out polypharmacy and potential drug-drug interactions among elderly patients admitted and discharged in Department of Medicine. This study was carried out on 100 patients above 65 years of age both males and females. Data was collected through review of case sheets. Polypharmacy was observed based on admission and discharge prescriptions. Frequently occurring drug-drug interactions were assessed using online checks. Mean number of drugs prescribed to patients on admission (7.61 ± 3.37) was more than that on discharge (5.48±2.46). More than half of these patients received 5 to 9 number of drugs. On admission 52.69% potential drug-drug interactions were observed and on discharge 52.91%. Most common drug interactions observed in both the groups were of moderate grade. From the present study we can conclude that polypharmacy leads to more potential drug-drug interactions. To improve drug safety in this high-risk population, appropriate prescribing is very important.

Is Reactive Dengue NS1Antigen Test a Warning Call for Hospital Admissions?

Dengue fever is a major public health problem worldwide. The 2011 revised World Health Organization (WHO) guidelines have emphasized on early diagnosis and intervention to reduce the case fatality rate due to dengue fever. Rapid diagnostic tests like NS1 antigen assays have improved the detection of cases in early clinical phase of illness but its role as a predictor of severe dengue infection is not very clear. To evaluate the utility of NS1 Ag assay as an early diagnostic marker and predictor of severe dengue infection. All children (0-12 years of age) diagnosed and confirmed with dengue fever at a tertiary care hospital in Puducherry between 01(st) August 2012 and 31(st) July 2015 were reviewed retrospectively from hospital case records as per the revised WHO guidelines for dengue fever. The diagnosis was confirmed by NS1antigen-based ELISA test or dengue serology for IgM and IgG antibodies and the data were analysed using SPSS 16.0 statistical software. After collecting all the data, all the variables were summarised by descriptive statistics. Categorical variables were expressed as frequencies and percentages, and then analysed by the χ(2) test or fishers exact test, where appropriate. Significance was taken at p-value< 0.05. Among the 261 confirmed cases of dengue fever non-severe dengue and severe dengue infection was seen in 60.9% and 39.1% respectively. The mean age of presentation was 6.9 years and M:F ratio was 1.2:1. NS1 Ag was positive in 217 cases (83.1%) and among them non-severe dengue and severe dengue was seen in 65.9% and 34.1% cases respectively. A total of 44 cases (16.9%) were negative for NS1 Ag assay and positive for IgM MAC ELISA and among them 16 children (36.4%) had non-severe dengue infection where as 28 children (63.6%) had severe dengue infection. Secondary infection with (MAC-ELISA IgG) was seen in 17 cases (6.5%). NS1Ag assay was predominantly positive in acute phase sera, where as IgM/IgG MAC ELISA was predominantly positive in convalescent phase sera. There were six deaths (2.3%) and the common causes of poor outcome were multiorgan failure, encephalopathy and refractory shock. NS1 Ag assay is a useful early diagnostic marker for dengue fever but cannot be used as an early predictor of severe dengue infection. The criteria for admission in hospitals of cases of dengue fever should be based on clinical warning signs rather than positive NS1 Antigen test.

Knowledge, Attitude and Practice of Biomedical waste management among health care personnel in a tertiary care hospital in Puducherry.

Background: Studies in India and other developing countries has shown lack of knowledge and poor practice of Biomedical waste management (BMW). Hence this study was undertaken to know the KAP of BMW in our hospital, to identify the gaps and to take necessary steps for rectification.Materials & Methods: This was an observational descriptive hospital based cross sectional study. The study group included the 337 healthcare personnel which included doctors(residents), nurses, laboratory technicians and multi-purpose workers. The study was done using a pre-tested semi-structured questionnaire. The data was analysed using software SPSS 20 version . Proportions were used for interpretation.Results: It showed that <50% of nursing staff and <25% of MPWs had the knowledge of colour coding and segregation. There was also poor knowledge regarding disposal of sharps among technicians and MPWs. It also brought to our notice that only 50% of the doctors (residents) and nursing staff and 26% of the laboratory technicians have undergone training in BMW management. None of the MPWs had received training regarding BMW management. They had good knowledge regarding the diseases transmitted through improper bio medical waste handling.Conclusion: This study revealed that there is the need to continue the training programme for BMW and to include technicians and MPWs in the programme. It also shows that the administration needs to put protocols, provide PPE and other resources for better compliance of BMW rules.

Bombay blood group: Is prevalence decreasing with urbanization and the decreasing rate of consanguineous marriage

Context:Bombay blood group although rare is found to be more prevalent in the Western and Southern states of India, believed to be associated with consanguineous marriage.Aims:To estimate the prevalence of the Bombay blood group (Oh) in the urban population of Puducherry. To find the effect of urbanization on consanguineous marriage and to establish whether consanguinity plays a part in the prevalence of Oh group. To compare Oh group prevalence with that of other neighboring states, where population is not predominantly urban.Settings and Design:This is a descriptive study in a tertiary care hospital in Puducherry, over a period of 6 years.Materials and Methods:All blood samples showing ‘O’ group were tested with anti-H lectin. Specialized tests like Adsorption Elution Technique, inhibition assay for determination of secretor status were performed on Oh positive cases. Any history of consanguineous marriage was recorded.Statistical Analysis Used:All variables were categorical variable and percentage and proportions were calculated manually.Results:Analysis of the results of 35,497 study subjects showed that the most common group was ‘O’ group constituting 14,164 (39.90%) of subjects. Only three “Oh” that is, Bombay phenotype (0.008%) were detected. Consanguinity was observed in two cases (66.66%).Conclusions:This study shows the prevalence of Bombay blood group representing the urban population of Puducherry, to be high (0.008%) and associated with consanguineous marriage (66.66%). Thus, consanguinity is still an important risk factor present, even in an urban population in Southern India.

Study of Surgical site infection in clean and clean contaminated surgeries in a tertiary care hospital

Background and objectives: Infection is an important cause of morbidity and mortality in surgical patients. Surgical site infections can occur anytime from zero to thirty days and affect either the incision or deep tissue at the operation site. Rapidly emerging nosocomial pathogens and the problem of multi-drug resistance necessitates periodic review of isolation patterns and sensitivity in surgical practice. This study aimed at evaluating the incidence of SSI in our hospital and the preventive measures which are already practised for reducing the SSI rate in our hospital. Materials and methods: A hospital based descriptive study conducted in a public tertiary care hospital in Puducherry. Data from 242 surgical patients were collected using a predesigned proforma and the patients were followed up for a period of 30 days following surgery to assess the occurrence of any infection at wound site. Results: During the study period data from 242 patients were collected. Out of these, 29 patients [12%] developed the surgical site infection. The incidence of SSI in clean surgeries was 11.1% and in clean-contaminated surgeries was 12.9%. The most common isolates were Staphylococcus aureus and MRSA [2 cases each] and all other isolates were obtained from single cases of SSI. Interpretation and conclusions: The incidence of SSI in our institute was found to be around 12% in clean and clean-contaminated surgeries. The pathogenic isolates from our institute were same as pathogens associated with SSI from other studies.

Knowledge, Awareness and Prevention of Cervical Cancer among Women Attending a Tertiary Care Hospital in Puducherry, India.

Cervical cancer is one of the most common cancers among women worldwide, with highest mortality in India. The incidence and mortality of cervical cancer can be reduced by screening women for precancerous lesion and by administration of human papilloma virus vaccine to adolescent girls. Knowledge of the women about cervical cancer and awareness about its prevention are the key factors that determine their utilization of screening services. A cross sectional survey of women attending Gynaecology Out-Patient Department (OPD) in a tertiary care hospital in Puducherry was conducted. Information about their knowledge of cervical cancer, awareness of its prevention and their socio demographic characters were collected. Mean age of the study population was 40.45 ± 12 years. Less than half of the study population (178, 44.5%) knew about cervical cancer. Less than one-fourth of the population knew about screening services for prevention of cervical cancer, and majority (389, 97.2%) were not aware of vaccination as prevention for cervical cancer. Our study population shows poor knowledge about cervical cancer and is unaware of the concept of prevention. Hence extensive health education to the public is needed regarding cervical cancer and its prevention.

Phenotypic Characterization and Antifungal Susceptibility Pattern to Fluconazole in Candida species Isolated from Vulvovaginal Candidiasis in a Tertiary Care Hospital.

Vaginal candidiasis is a common gynecological finding among women worldwide. This study was carried out to determine the prevalence of vulvovaginal candidiasis (VVC) along with speciation of Candida with special reference to its antifungal susceptibility pattern to fluconazole and also to evaluate the risk factors responsible for VVC in patients attending our tertiary care hospital in Puducherry, India. This study was carried out in the tertiary care hospital in Puducherry during the period of August 2010 to September 2012.The study group consisted of 180 women between the age group of 15 to 56 years with the complaints of excessive vaginal discharge, pruritis and pain. Materials used for this study consisted of high vaginal swabs from patients with relevant history, attending Obstetrics & Gynecology department. High vaginal swabs were subjected to direct 10% KOH wet mount microscopy, Gram stain, culture onto Sabouraud's dextrose agar (SDA) & 5% sheep blood agar and susceptibility testing to fluconazole was performed using E-test. Candida was isolated in 40 (22.2 %) women & these consisted of C. albicans 26 (65%), C. glabrata 9 (22.5%), C.tropicalis 3 (7.5%) & C. parapsilosis 2 (5%). Susceptibility test carried out on the 40 isolates revealed that 35 (87.5%) Candida isolates were sensitive to fluconazole, 3 (7.5%) were moderately sensitive and 2 (2.5%) were resistant. Thirty one percent patients had itching as the presenting complaints followed by vaginal discharge (29.4%). The high frequency with which C. albicans was recovered in our study and its susceptibility to fluconazole supports the continued use of azole agents for empirical therapy of uncomplicated candidal vulvovaginitis in the community.

Evaluation of Effect of Antiepileptic Drugs on Serum Lipid Profile among Young Adults with Epilepsy in a Tertiary Care Hospital in Pondicherry.

Several studies have reported that commonly used antiepileptic drugs like phenytoin, and carbamazepine increase serum High Density Lipoproteins Cholesterol (HDL-C) levels, while some others documented no such effect. Further, some researchers also observed that valproic acid and other newer antiepileptic drugs like lamotrigine and levetiracetam has no influence on serum lipid profile. The present study was planned to assess and compare serum lipid profile of young adult patients on commonly used antiepileptic drugs (phenytoin, oxcarbazepine and valproic acid) and newer antiepileptic drug (levetiracetam) attending Neurology OPD of a tertiary care hospital in Puducherry, India compared to normal subjects. A prospective hospital based cross-sectional study was conducted in Tertiary care hospital. Epileptic patients attending Department of Neurology and taking antiepileptic drugs for last six months or more and on regular follow up; approximately 60 patients on commonly used antiepileptic drugs (20 on phenytoin, 20 on oxcarbazepine, 20 on valproic Acid) and 20 patients on newer antiepileptic drug (levetiracetam) was included in the study. Age and sex matching 80 controls were taken. Descriptive statistics explained using mean ± SD. Inferential statistics was used depending on the nature of variables. We used one-way-ANOVA and followed by independent t-test for comparison with control group and statistically significant was considered at p-value <0.05. We observed statistically significant high mean TC, HDL-C, LDL-C and TG levels in the group receiving phenytoin for more than six months when compared with control group. We observed statistically significant high mean TC, HDL-C and TG levels in the group receiving oxcarbazepine for more than six months when compared with control. However, no significant difference was observed in mean LDL-C levels when compared to control. We did not observe any statistically significant difference among mean TC, HDL-C, LDL-C and TG levels in the group receiving valproate. We did not observe any statistically significant difference among mean TC, HDL-C, LDL-C and TG levels in the group receiving levetiracetam. From the present study we can conclude that CYP enzyme inducer anti epileptic medicines like phenytoin and oxcarbazepine is strongly associated with increased levels of TC, LDL-C, HDL-C and TG where as valproate and levetiracetam showed no significant change. Therefore, the serum cholesterol level should be regularly monitored in patients undergoing therapy with inducer anti epileptic medicines.