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Introduction: Tuberculosis (TB) is among the top 10 leading causes of death globally. Association of Adverse Drug Reactions (ADRs) with Anti Tubercular Therapy (ATT) drugs has been encountered more commonly which causes significant morbidity and even mortality. Aim: To find out the predisposing factors and to assess the causality, severity and avoidability of the ADRs in proven TB patients treated under Directly Observed Treatment Shortcourse (DOTS) regimen. Materials and Methods: This study was conducted at the Department of Respiratory Medicine, King George's Medical University, Lucknow. TB patients who were kept on DOTS regimen under Revised National Tuberculosis Control Programme (RNTCP), satisfying the inclusion and exclusion criteria with written informed consent, were recruited and monitored from May 2016 to April 2017. A total of 115 patients were enrolled for the study. TB diagnosis was confirmed by sputum smear. The treatment was initiated as per Category I-newly diagnosed patients of TB and Category II-previously treated patients pending drug sensitivity testing result (According to Treatment of TB: Guidelines, 4th edition, 2010, WHO, Geneva). The patients were followed up and monitored for suspected ADRs. For causality assessment Naranjo's algorithm and WHO-UMC classification scales, for severity assessment Modified Hartwig and Siegel Scale according to severity levels, for avoidability assessment Halla's scale were used. Categorical variables were presented in number and percentage (%). Chi-Square test/Fisher's-exact test was used for the comparison of qualitative variables. The p-value of <0.05 was considered statistically significant. Results: Out of 115 patients enrolled, 87 ADRs were observed in 67 cases. Incidence of ADRs were more in patients of TB with Diabetes Mellitus (DM) (79.16%) and with HIV (70.59%) than in patients of TB without diabetes (52.75%) and without HIV (56.12%). Naranjo's causality assessment accounted 47.12% of the ADRs as "probable", 51.72% as "possible", 1.15% as "doubtful". WHO-UMC causality assessment scale accounted 43.68% as "probable", 44.82% as "possible", 8.05% as "unlikely", and 3.44% as "unclassified". Modified Hartwig and Siegel Scale for assessment of severity of ADRs showed 70.11% as mild, 27.58% as moderate and 2.29% as severe. Halla's avoidability assessment scale showed 44.83% ADRs as 'not avoidable', 48.28% as 'possibly avoidable', 4.59% as 'not evaluable', and 2.29% as 'definitely avoidable'. Conclusion: Regular and vigilant drug monitoring of various ADRs can improve the clinical outcome, quality of life as well as patient adherence towards treatment. Results of this study can help to promote safer drug use and increase awareness regarding these ADRs. Data obtained can be used as a guide to make future decisions regarding therapy and risk benefit assessment of drugs in therapy. [ABSTRACT FROM AUTHOR]

Introduction: Hyperlipidaemia is a well known risk factor for cardiovascular diseases. Lifestyle modification can be the initial step to reduce cholesterol levels. There are various drugs which are used to control dyslipidaemia. Treatment of lipid abnormalities is a lifelong battle. Moreover, the safety and effectiveness of long term lipid lowering treatment are questionable. Gymnema Sylvestre (GS) is a well known herb with various medicinal properties. Aim: To explore the hypolipidaemic activity of GS leaves extract. Materials and Methods: Adult healthy female wistar rats, 30 in number, divided into five groups, weighing 150- 200 g were used. Dyslipidaemia was induced in rats by feeding them on high fat diet for four weeks. For the next four weeks GS extract was used as test drug while Atorvastatin was used as standard drug. Blood sample was collected for estimation of lipid profile on day 0, week 4 and week 8. Data was recorded as mean±SEM (Standard error of mean). Paired t-test and one way Analysis of Variance (ANOVA) followed by Dunnett's post hoc test was used for comparison. A p-value <0.05 was considered statistically significant. SPSS Statistics 20 (IBM software) was used for the analysis. Results: Feeding rats with high fat diet for four weeks led to obesity and dyslipidaemia in rats. GS at both the doses (100mg/ kg and 200mg/kg) significantly improved the lipid profile. Total Cholesterol (TC), Triglycerides (TG), Very Low Density Lipoprotein (VLDL) and Low Density Lipoprotein (LDL) values reduced significantly while that of High Density Lipoprotein (HDL) increased significantly. GS 200 mg/kg was found more effective than GS 100 mg/kg. GS improved the value of lipid profile significantly but the effect was found inferior to Atorvastatin. Conclusion: From the present study it can be concluded that GS possess an effective hypolipidaemic effect. Hence it can be included as an add on therapy in dyslipidaemia after further confirmatory studies. [ABSTRACT FROM AUTHOR]