International Journal of Integrative Medical Sciences

Number 5, 2015

115-120
Randomized Control Trial of IVIG as An Adjuvant in the Treatment of Preterm and or Low Birth Weight Neonatal Sepsis

Authors: Sekar M.N, Anjan Kumar VS, Ravi Kumar P, Siva Ramudu K, Mallikarjuna M, Sasi Kumar B

Abstract

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Number of views: 316

Introduction: In developing countries neonatal sepsis ranks as most common illness responsible for neonatal mortality especially in low birth weight and preterm babies. In India, it is responsible for 25-50% of neonatal deaths in spite of early diagnosis and treatment. There have been many trials on various adjuvant therapies (like leukocyte transfer,GCSF, GMCSF, fibronectin, IVIG, FFP) in addition to specific antimicrobial therapy. There is still some controversy in the role of IVIG in treatment of neonatal sepsis. Hence the study was undertaken to evaluate the efficacy of IVIG in treatment of neonatal sepsis. Materials and Methods: 30 in group total 60 babieswith gestation < 32 wks and wt < 2000 gmwere enrolled in the study if they had one or more clinical features of sepsis and had elevated C –reactive protein (>10mg/dl). Babies in both groups underwent investigations includingmicro ESR,WBC count, ANC, Platelet count, LFT, Blood culture & Urine culture. In IVIG group samples were drawn before giving IVIG. Results: There is no significant decrease in mortality, severity of illness and duration of hospital stay in IVIG group than control group. Conclusions: As of other studies, our study also did not show any significant role of IVIG as an adjuvant in the treatment of sepsis in preterm or low birth weight neonates. KEYWORDS: Leukocyte transfer,GCSF, GMCSF, Fibronectin, IVIG and FFP.

121-127
Problem Based Learning (PBL) for Large Groups Medical Students e-Problem Solving Test: A Mutation Causing Retinoblastoma (Rb)

Authors: Kumar Ponnusamy, Jegathambigai Rameshwar Naidu, Ravindra Kumar Boddeti, Prejna Barki.

Abstract

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Number of views: 319

E-learning can be used to enhance and aid the implementation of problem-based learning (PBL). Through e-learning, learning can take place anywhere and anytime through the communication tools that it has. This feature provides a channel of communication among medical students and content experts in medicine that is not bounded by the class time and physical presence. Therefore, e-learning has been identified as a learning system that can greatly enhance the implementation of PBL among undergraduate-medical students. Conceptmaps can be successfully used to teach conceptual thinking, thus increasing students’ competence in critical thinking in the modern paradigm. The purpose of this paper is to put forth effective strategies for utilizing elearning in PBL formedical and allied health science education with amodel PBL on Retinoblastoma (Rb). Some effective strategies that have been identified are: (a) the use of online-learning tool to deliver structured assigned independent e-PBL problems to students, (b) content expert-facilitator-initiated communication for the PBL case scenario on the e-learning platform, (c) frequent availability of content expert on-medical education online for facilitation, and (d) the use of online resources such as relevant case scenarios, videos, research component such as reviewjournal for reflection, construction of conceptmaps and assessment. These strategies will enable amore efficient and effective implementation of out-come based self-directed structured assigned independent learning e-PBLs related to difference modules ofmedicine, with relatively less number of content experts and in short time for large group of medical and allied health sciences students. KEY WORDS: e-learning, e-problem based learning, Medical science education, Interactivity, Supplemental digital content, Research components, Conceptmapping, Retinoblastoma.

128-132
St John’s Wort and Related Drug Interactions: A Review

Authors: Sujit Kumar Sarker, Ratna Paul, Himel Pal, Soe Wunna Shwe.

Abstract

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Number of views: 351

Introduction: St John’swort (HypericumperforatumL.) is a perennial plant that has transparent perforations on its leaves. It has been used as medicinal herb since ancient time. Medicinal values:Many bioactive compounds have been isolated fromSt John’swort. Among those compounds hypericin and hyperforin are well studied. Both have antidepressant effects. This herb has also antineoplastic, antiviral and many other effects. Oil macerates are also used in wound healing. St John’s wort extracts are used as complementary medicine in many countries. Pharmacology: Few studies suggests that it inhibitsmonoamine oxidase and re-uptake of serotonin, dopamine and norepinephrine. But it causes induction of liver cytochrome oxidase enzymes and also causesmany adverse effects including mania and photosensitivity. Drug interactions:Most of the drug interactions occur due to its enzyme induction properties. It can also reduce plasma concentration of antidepressants like amitriptyline and SSRI. It increases serotonergic effects of antidepressants such as duloxetine and venlafaxine. Data suggests that it has significant interactions with antiepileptics, combined oral contraceptives, calcium channel blockers, lipid regulating drugs (statins), antivirals and many more. Conclusion: Although most popular use of St John’s wort is mild to moderate depression, it should be taken under supervision of physician as many cases its concomitant uses are not advisable. KEY WORDS: St John’s wort, Drug interactions.