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Introduction: Hypertension is a global public health issue.Hypertensive heart disease is one of the top ten leading causes of death in the world.Hypertension is also a major contributor to the global disease burden of cardiovascular and cerebrovascular disease.Poor adherence to medications is one of the major public health issue and challenge. Only one-third of the population reported successful control of blood pressure.Despite of the availability for effective treatment, over half of the patients being treated for hypertension drop out of care entirely within a year of diagnosis.Recent research suggests that poor adherence and poor compliance to antihypertensive medication (AHM) is a major hurdle in the management of hypertension and is usually associated with bad outcome of the disease and wastage of limited health care resources.Adherence to antihypertensive medication is a very effective step for controlling blood pressure and preventing complications.To prevent some of the complications of hypertension regular intake of the prescribed treatment in the form of medicines (pills) is very essential and important.The current study aimed to assess the level of compliance of hypertensive patients to their anti-hypertensive medications and to determine the socio-demographic correlates of compliance. Methods: A total of 512 patients were enrolled from the Department of Internal Medicine at King George's Medical University (KGMU), Lucknow according to the American Heart Association ( AHA ) guidelines. Both male and female patients of age between 35-75 years on anti – hypertensive medications, providing written consent were included in the study.An institutional-based descriptive crosssectional study was conducted among hypertensive patients.A simple random sampling technique was used to select the study participants from the study population. Sociodemographic data, medication adherence, factors affecting adherence were collected using a structured questionnaire and an 8-item Morisky Medication Adherence Scale questionnaire was used to assess the level of adherence. The questionnaire had 8 questions and a score of 7 or 8 was classified as good adherence, 6 as moderate, and less than 6 as non adherence. On each visit at the OPD the questionnaire was provided to the patients. Results: A total of 62 patients were lost to follow-up, resulting in 450 patients out of 512 having hypertension further completed the study.The mean (±SD) age of the study participants was 54.5 (±10.6) years.Medication adherence was good among 115 (25.6%) patients and moderate among 165 (36.7%); 170 (37.8%) patients were nonadherent. Most patients (72.7%) had uncontrolled hypertension. Nearly half (49.6%) were unable to afford monthly medication.In bivariate analysis, nonadherence was associated with female sex (odds ratio [OR], 1.44; P = .003) and long waiting times in the health care facility (OR, 2.93; P = .005); the presence of comorbidities (OR, 0.62; P = .01) was associated with good adherence. In multivariate analysis, nonadherence was associated with unaffordability of treatment (OR, 2.25; P = .002) and uncontrolled hypertension (OR, 3.16; P < .001). Good adherence determinants included adequate counseling (OR, 0.29; P < .001) and education (OR, 0.61; P = .02).The analysis was done using proportions and Chi-square test . Binary logistic regression analysis was performed to determine covariates associated with medication adherence. Conclusion: Low level of knowledge regarding hypertension related complications or associated risk factors was also noted.Patient education, family counselling, social support networks and also the use and importance of gadgets should be strengthened in health promotion programs in order to enhance compliance of hypertensive patients with the therapeutic regimen and to improve their quality of life. The level of poor adherence to antihypertensive medications and low level of knowledge on hypertension was a point of concern.The status of blood pressure control was significantly associated with the pattern of adherence.The barriers to adherence were cost of drug and more number of pills per day. [ABSTRACT FROM AUTHOR]

Introduction: Doxazosin is an alpha-1 antagonist used for the treatment of benign prostatic hypertrophy (BPH) symptoms and hypertension. An α (1)-adrenergic receptor antagonist called Doxazosin is used to treat benign prostatic hyperplasia and excessive blood pressure. There is evidence linking peripheral α-adrenergic receptors to inflammation. Aim and Objective: To study the antidepressant effect of Doxazosin by an experimental model in swiss albino mice. Material and Methods: The study was conducted in the Department of Pharmacology & Therapeutics at King George’s Medical University, Lucknow. The present study was designed to evaluate antidepressant in an experimental model in Swiss albino mice. A total number of 18 female Swiss albino mice were included in the study. They were kept in the institutional animal house under standard conditions. They received normal pellet diet and water ad libitum. They were allowed to get acclimatized to the new environment for a period of 2 weeks. Mice were randomly divided into 3 groups, each group containing 6 mice. Results: In the present study antidepressant activity was observed by the period of immobility in Forced swim test. Each activity was conducted on 18 mice, 6 mice in each group (Group A: Vehicle, Group B: Doxazosin, Group C: Imipramine). Therefore on Day 1, period of immobility of mice in the above 3 groups was found to be comparable. On Day 11, period of immobility of mice in the above 3 groups was found to be comparable again. It was observed that there was a slight decrease in period of immobility indicating that Doxazosin (4 mg/kg) may have some weak antidepressant activity at Day 21. Decreasing period of immobility significantly more than control indicating that Doxazosin (4 mg/kg) may have moderate antidepressant activity at Day 31. Conclusion: Doxazosin (4 mg/kg) appeared to be a promising therapy option for patients presenting with depression. [ABSTRACT FROM AUTHOR]

BACKGROUND: Students make their decision on a future medical career while experiencing different areas of medical specialties based on their perceptions and preferences. OBJECTIVE: The objective of the study is to explore the factors and perceptions of undergraduate medical students which influence their choice of postgraduate specialization. MATERIALS AND METHODS: This cross-sectional study was conducted in the year 2022 among 257 2nd year undergraduate medical students who were queried about possible factors that might influence their choice of specialization. The factors were grouped as intrinsic factors (personal attributes and preferences); and extrinsic factors (nature of work and working environment). Data entry and analysis were done in SPSS version 23. RESULTS: Final analysis was done on 235 students out of a total of 257 students (response rate of 91.43%). Majority (86.4%) were 19-20 years of age, with mean (±standard deviation) age of 19.8 (±0.9) years. Gender preference was observed to affect choices of a few specialties such as orthopedics and obstetrics/gynecology. Motivating factors for choosing a certain specialization were the perception of a better quality of life (84.7%); financial rewards (26.8%); and less work pressure (23.4%). Most of our medical students claimed that the selection of their specialty was based on prior clinical posting (65.5%) and influenced by teaching faculty and hospital consultants (59.6%). 8.1% of the students reported that COVID affected their choice of specialty. Specialization in pre- and para-clinical subjects was preferred by 3.4% (n = 8) of the participants. CONCLUSIONS: The study identified a mix of both intrinsic and extrinsic factors influencing, motivating, and guiding their choice. Specialized careers support programs may be integrated into the curriculum following an analysis of students' perceptions in different disciplines. [ABSTRACT FROM AUTHOR]

Background: India is amongst one of the high multidrug resistant tuberculosis (MDR-TB) burden countries globally with a huge contribution given by the state of Uttar Pradesh. Programmatic Management of Drug Resistant Tuberculosis, initiated in 2007 has taken over the disorganized and unsupervised treatment practice in India. However, regular scrutiny is required which points out both its success and failure. Aim & Objective: This study was conducted to evaluate final treatment outcomes among MDR-TB patients on standard Category IV regimen Settings and Design: Retrospective analysis was done using secondary data from medical records of all patients. Methods and Material: Data of all MDR-TB patients registered under RNTCP at King George's Medical University, Lucknow from 2013 to 2016 was collected. Demographic details along with pre-defined treatment outcomes were recorded (cured, treatment completed, death, treatment failure, treatment default and transfer to higher centre). Statistical analysis used: Descriptive statistics using numbers and percentage. Results: The records of 3580 MDR tuberculosis patients registered at drug resistant tuberculosis centre in King George's Medical University from January 2013 to December 2016 were included which consisted of 67%males and 33%female. Mean age of presentation was 31.17 years (95% CI 30.75-31.59). Mean weight of patients was 40.16 kg (95% CI 39.89-40.43). Year wise distribution of registered cases from 2013 to 2016 was 611, 799, 984 and 1186 patients respectively. Amongst 3580 patients, 30.39% were declared cured, 25.50% completed treatment, 21.39% died, 0.84% showed treatment failure, 12.54% were defaulters, 2.35% were transferred out to higher centre, 6.5% were shifted to regimen for Extensive drug resistant (EDR) TB, 0.16% patients needed to stop treatment due to ADR and 0.33% patient were still on treatment. Conclusion: The treatment success rate of MDR-TB patients is still low. Measures to improve treatment adherence as in National tuberculosis elimination programme (NTEP) attempts to further improve the success rate. [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]

Background: Increasing incidence of tuberculosis is intensifying the posttubercular obstructive airway disease (PTOAD) in developing countries. Currently, there are no standard treatment guidelines for the management of PTOAD patients. The present study aims to evaluate the prescribing pattern, adherence, adverse drug reactions (ADRs), and quality of life (QoL) in PTOAD patients., Materials and Methods: A prospective observational study was conducted to evaluate the prescriptions of PTOAD patients, estimating the medical adherence using Morisky 8-Item Medication Adherence Questionnaire, assessing ADRs using Hartwig's Severity Assessment Scale and assessing QoL using St. George's respiratory Questionnaire. Chi-square test, analysis of variance, paired t -test were used to compare the data. The significance of change in adherence status was assessed by Wilcoxon signed-rank test., Results: A total of 94 prescriptions of PTOAD were analyzed. Inhaled long-acting muscarinic antagonist was prescribed to 31.9% of patients. The most common inhaled fixed dose combination was long-acting beta-2 agonist with corticosteroid, prescribed to 52.1% of patients. At final follow-up, maximum percentage of patients were found to be highly adherent, i.e. 56.4%. Overall, 34% of patients have complained about mild category of ADRs. A significant improvement in QoL was observed. At baseline, mean forced expiratory volume in 1 (FEV 1 ) was 64.66% ±23.61%, which increased significantly to 73.34% ±21.60% on final follow-up ( P < 0.001)., Conclusion: Bronchodilators are the mainstay of treatment of PTOAD patients, since both the QoL and FEV1 were improved with treatments. However, to have good treatment outcome, strict adherence along with safety of the medications must be assured., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Perspectives in Clinical Research.)