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Sil A, Kumar H, Mondal RD, Anand SS, Ghosal A, Datta A, Sawant SV, Kapatkar V, Kadhe G, Rao S. A randomized, open labeled study comparing the serum levels of cobalamin after three doses of 500 mcg vs. a single dose methylcobalamin of 1500 mcg in patients with peripheral neuropathy. Korean J Pain 2018; 31:183-190. [PMID: 30013732 PMCID: PMC6037815 DOI: 10.3344/kjp.2018.31.3.183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 04/25/2018] [Accepted: 05/14/2018] [Indexed: 11/12/2022] Open
Abstract
Background Vitamin B12 deficiency has been associated with peripheral neuropathy, loss of sensation in the peripheral nerves, and weakness in the lower extremities. Methylcobalamin is the most effective analogue of vitamin B12 used to treat or prevent the complications associated with vitamin B12 deficiency. The current study aimed to compare the serum cobalamin levels after administration of two different regimes of methylcobalamin in peripheral neuropathy patients. Methods The present study was a prospective, randomized, comparative study. The study consisted of two parallel groups, group A (methylcobalamin 500 µg injection intramuscularly three times a week) and group B (methylcobalamin 1500 µg injection intramuscularly once a week). A control group of healthy volunteers was also included. Results A total of 24 patients (12 in each group) were included in the study. Five healthy volunteers were also included as a control in each group. At the end of treatment, serum cobalamin levels were significantly (P = 0.028) higher in group A (1892.08 ± 234.50) as compared with group B (1438.5 ± 460.32). The serum cobalamin levels in Group A healthy volunteers were also two times higher than that of group B (P = 0.056). Both the LANSS scale and DN4 questionnaire reported similar results at end of treatment. Conclusions The 500 µg methylcobalamin thrice weekly regime is more effective in increasing the serum cobalamin levels as compared to the 1500 µg methylcobalamin once weekly regime.
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Affiliation(s)
- Amrita Sil
- Department of Pharmacology, IPGME&R, Kolkata, India
| | - Hrishikesh Kumar
- Department of Neuromedicine, Institute of Neurosciences, Kolkata, India
| | - Rahul Deb Mondal
- Department of Neuromedicine, Institute of Neurosciences, Kolkata, India
| | | | - Anirban Ghosal
- Department of Neuromedicine, Institute of Neurosciences, Kolkata, India
| | - Ashis Datta
- Department of Neuromedicine, Institute of Neurosciences, Kolkata, India
| | - Sandesh V Sawant
- Wockhardt Limited, Wockhardt Towers, Bandra Kurla Complex, Mumbai, India
| | - Vaibhavi Kapatkar
- Wockhardt Limited, Wockhardt Towers, Bandra Kurla Complex, Mumbai, India
| | - Ganesh Kadhe
- Wockhardt Limited, Wockhardt Towers, Bandra Kurla Complex, Mumbai, India
| | - Sameer Rao
- Wockhardt Limited, Wockhardt Towers, Bandra Kurla Complex, Mumbai, India
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Mehta Y, Sunavala JD, Zirpe K, Tyagi N, Garg S, Sinha S, Shankar B, Chakravarti S, Sivakumar MN, Sahu S, Rangappa P, Banerjee T, Joshi A, Kadhe G. Practice Guidelines for Nutrition in Critically Ill Patients: A Relook for Indian Scenario. Indian J Crit Care Med 2018; 22:263-273. [PMID: 29743765 PMCID: PMC5930530 DOI: 10.4103/ijccm.ijccm_3_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background and Aim: Intensive-care practices and settings may differ for India in comparison to other countries. While international guidelines are available to direct the use of enteral nutrition (EN), there are no recommendations specific to Indian settings. Advisory board meetings were arranged to develop the practice guidelines specific to Indian context, for the use of EN in critically ill patients and to overcome challenges in this field. Methods: Various existing guidelines, meta-analyses, randomized controlled trials, controlled trials, and review articles were reviewed for their contextual relevance and strength. A systematic grading of practice guidelines by advisory board was done based on strength of the supporting evidence. Wherever Indian studies were not available, references were taken from the international guidelines. Results: Based on the literature review, the recommendations for developing the practice guidelines were made as per the grading criteria agreed upon by the advisory board. The recommendations were to address challenges regarding EN versus parenteral nutrition; nutrition screening and assessment; nutrition in hemodynamically unstable; route of nutrition; tube feeding and challenges; tolerance; optimum calorie-protein requirements; selection of appropriate enteral feeding formula; micronutrients and immune-nutrients; standard nutrition in hepatic, renal, and respiratory diseases and documentation of nutrition practices. Conclusion: This paper summarizes the optimum nutrition practices for critically ill patients. The possible solutions to overcome the challenges in this field are presented as practice guidelines at the end of each section. These guidelines are expected to provide guidance in critical care settings regarding appropriate critical-care nutrition practices and to set up Intensive Care Unit nutrition protocols.
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Affiliation(s)
- Yatin Mehta
- Department of Critical Care, Institute of Critical Care and Anesthesiology, Medanta the Medicity, Gurugram, Haryana, India
| | - J D Sunavala
- Department of Critical Care Medicine, Jaslok Hospital, Mumbai, India
| | - Kapil Zirpe
- Department of Critical Care Medicine, Intensive Care and Neurotrauma - Stroke Unit, Ruby Hall Clinic, Pune, Maharashtra, India
| | - Niraj Tyagi
- Department of Intensive Care and Emergency Medicine, Sir Gangaram Hospital, New Delhi, India
| | - Sunil Garg
- Department of Critical Care Medicine, Max Hospital, New Delhi, India
| | - Saswati Sinha
- Department of Critical Care Medicine, AMRI Hospitals, Kolkata, West Bengal, India
| | | | - Sanghamitra Chakravarti
- Department of Nutrition and Dietetics, Medica Superspeciality Hospital, Kolkata, West Bengal, India
| | - M N Sivakumar
- Department of Critical Care Medicine, KMCH, Coimbatore, Tamil Nadu, India
| | - Sambit Sahu
- Department of Critical care Medicine, KIMS Hospital, Hyderabad, Telangana, India
| | - Pradeep Rangappa
- Department of Intensive Care Medicine, Columbia Asia Hospitals, Bengaluru, Karnataka, India
| | - Tanmay Banerjee
- Department of Intensive Care Medicine, Medica Institute of Critical Care, Medica Super speciality Hospital, Kolkata, West Bengal, India
| | - Anshu Joshi
- Department of Scientific and Medical Affairs, Abbott Nutrition International, ANI-, Mumbai, India
| | - Ganesh Kadhe
- Department of Scientific and Medical Affairs, Abbott Nutrition International, ANI-, Mumbai, India
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Abstract
Changing epidemiology of Hepatitis A virus (HAV) has led to an increased susceptibility of adolescents and adults to the infection. Vaccination can remarkably reduce the incidence and associated morbidity of HAV infection. This review is focused on the safety and efficacy of H2 strain derived live attenuated Hepatitis A vaccine. We found the vaccine to be highly immunogenic with minimal or negligible safety issues. Moreover, a single dose of live attenuated vaccine persists a long term immune response and can be a preferred option for developing countries. In 2014, Indian Academy of Paediatrics (IAP) also updated their recommendations for H2 vaccine as a single dose as against the previous 2 dose schedule. A focused approach to include the vaccine in national immunization program should be explored.
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Affiliation(s)
- Sameer Rao
- a Medical Affairs Department , Wockhardt Ltd , Bandra (East), Mumbai , India
| | - J S Mao
- b Institute of Viral Diseases, Zhejiang Academy of Medical Sciences , Hangzhou , China
| | - Salman Motlekar
- a Medical Affairs Department , Wockhardt Ltd , Bandra (East), Mumbai , India
| | - Zhuang Fangcheng
- b Institute of Viral Diseases, Zhejiang Academy of Medical Sciences , Hangzhou , China
| | - Ganesh Kadhe
- a Medical Affairs Department , Wockhardt Ltd , Bandra (East), Mumbai , India
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Paramesh H, Nagaraju K, Sukumaran TU, Agarkhedkar S, Bhakta S, Tilak R, Vijayasekaran D, Narayanan V, Mane A, Phansalkar A, Kadhe G. Airway Diseases Education and Expertise (ADEX ) in Pediatrics: Adaptation for Clinical Practice in India. Indian Pediatr 2017; 53:154-8. [PMID: 26897152 DOI: 10.1007/s13312-016-0812-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
JUSTIFICATION Asthma and allergic rhinitis together are part of the concept of one airway, one disease or united airway disease. The management of allergic airway diseases should address this united concept and manage the issue by educating the patients and their parents and health care providers, along with environmental control measures, pharmacotherapy and immunotherapy. Here, we present recommendations from the module of Airway Diseases Education and Expertise (ADEX) that focused on allergic rhinitis, asthma and sleep disorder breathing as a single entity or Allergic Airway Disease. PROCESS A working committee was formed by the collaboration of Pediatric Allergy Association of India (PAAI) and Indian Academy of Pediatrics (IAP) Allergy and Applied Immunology chapter to develop a training module on united airway disease. OBJECTIVE To increase awareness, understanding and acceptance of the concept of United Airway disease and to educate the primary health care providers for children and public health officials, in the management of united airway diseases. RECOMMENDATIONS Recommendations for diagnosis, management and follow-up of Allergic airway disease are presented in this document. A better compliance by linking education of child, parent, grandparents and other health care providers, and scientific progress by collaboration between practitioners, academicians, researchers and pharmaceutical companies is suggested.
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Affiliation(s)
- H Paramesh
- From ADEX working group, Indian Academy of Pediatrics Allergy and Applied Imunology Chapter, Indian Academy of Pediatrics, India. Correspondence to: Dr H Paramesh, Sirona Center for Health Promotion, Bengaluru 560094, Karnataka, India.
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Bhagat S, Kapatkar VK, Mourya M, Roy S, Jha S, Reddy R, Kadhe G, Mane A, Sawant S. Potential Risks and Mitigation Strategies Before the Conduct of a Clinical Trial: An Industry Perspective. Rev Recent Clin Trials 2016; 11:47-55. [PMID: 26435140 DOI: 10.2174/1574887110666151005110751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/30/2015] [Accepted: 09/22/2015] [Indexed: 11/22/2022]
Abstract
Conduct of clinical trials has undergone substantial changes over the last two decades. Newer markets, evolving guidelines and documentation and high cost involved in conducting the trials have led pharmaceutical companies to prepare a risk mitigation plan. Extensive monitoring of potential risks is an essential element of clinical trials which helps to ensure quality and integrity of a clinical investigation. Every clinical trial has pre (before the trial), conduct and post phase. This article which has been developed as a result of extensive research at ground level by a reputed pharmaceutical company to identify the potential stages of risks that could affect the overall quality and safety of a trial and its outcome during the pre-phase of trial (the stage of the trial where the study design is being planned before initiation of the clinical trial). It includes risks associated with basic study concept, protocol design, Confidential Disclosure Agreement (CDA) and Clinical Trial Authorization (CTA) application signing, vendors of central drug laboratory, site and investigator selection, Clinical Research Coordinator (CRC) meet, Informed Consent Form (ICF), Case Report Form (CRF)/ Status Report Form (SRF) preparation, Ethics Committee (EC) submission, etc. have been highlighted. The risk based mitigation strategy (to develop an effective risk monitoring plan before staring a clinical trial) has also been suggested by authors. A well-tailored and integrated plan, recognition of potential risks and their mitigation strategy can result in the pre exclusion or end to end solution of all the risks associated with pre- phase of clinical trials.
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Affiliation(s)
| | - Vaibhavi K Kapatkar
- Wockhardt Limited, Wockhardt Towers, Bandra Kurla Complex, Mumbai - 400 051 (India).
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Swamy S, Mourya M, Kadhe G, Mane A, Sawant S. Safety reporting through a comprehensive and pragmatic pharmcovigilance process for India and emerging markets: an industry perspective. Expert Opin Drug Saf 2016; 14:1409-20. [PMID: 26292785 DOI: 10.1517/14740338.2015.1071792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Pharmacovigilance (PV) deals with the drug-related adverse reactions ensuring patients' safety. Emerging markets of India, South East Asia (SEA), Russia, Latin America (LA), Middle East and North Africa (MENA) have developed their own PV programs. However, under/manual reporting accompanied with lack of awareness regarding adverse drug reactions (ADRs) are major drawbacks that continue to exist due to lack of co-ordination and disparity in the regulatory approach. AREAS COVERED Of the 118 studies identified using various databases, 60 were included for the review. The authors discuss the present PV scenario of India, SEA, Russia, LA and MENA, and explain a basic process for uniform PV data input-output across industry, which includes data collection, analysis, processing, causality assessment and data distribution systems. EXPERT OPINION As the number of clinical trials conducted are rising in the emerging markets, there is a need to understand and implement a robust PV system, where electronically globalized, evidence based, public health oriented and regulatory compliant PV system is established. This would also improve transparency in system and ensure enhancement in safety data reporting ensuring premature and trouble-free detection of ADRs. It might result in implementing various PV boosting activities, which could yield robust patient safety data from India and emerging markets.
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Affiliation(s)
- Shashidhar Swamy
- a 1 Wockhardt Limited , Wockhardt Towers, Bandra Kurla Complex, Mumbai, India +91 99 20 168 771 ;
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Chatterjee S, Dureja GP, Kadhe G, Mane A, Phansalkar AA, Sawant S, Kapatkar V. Cross-Sectional Study for Prevalence of Non-Steroidal Anti-Inflammatory Drug-Induced Gastrointestinal, Cardiac and Renal Complications in India: Interim Report. Gastroenterology Res 2015; 8:216-221. [PMID: 27785299 PMCID: PMC5040529 DOI: 10.14740/gr658w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Non-steroidal anti-inflammatory drugs (NSAIDs) are the most common therapeutic products used for the management of inflammation and pain. However, their use is associated with gastrointestinal (GI), cardiovascular and renal complications. Although prevalence data regarding NSAID-induced complications are available worldwide, but none of the study has assessed the prevalence of GI, cardiac and renal complications in India. This study aimed to assess the point prevalence of GI, cardiac and renal complications associated with the use of NSAIDs in India. The study also aimed to evaluate the association between the risk factors and GI, renal and cardiac complications in patients using NSAIDs. METHODS This prospective, cross-sectional, multi-centric study was conducted in eight medical colleges across India (North, East, West, South and Central India). Data related to GI complications including gastric, duodenal and gastroduodenal erosions/ulcers/gastritis, renal complications including acute and chronic renal failure or cardiac complications including acute coronary syndrome (ACS), acute myocardial infarction (AMI) and cardiac failure, were collected from patients. RESULTS The cut-off date for interim data analysis was July 7, 2014. A total of 2,140 patients out of 3,600 were enrolled from eight centers at the time of interim analysis. The NSAID-associated point prevalence of GI complications was 30.08%; cardiac complication was 42.77%; and renal complication was 27.88%. CONCLUSIONS Results of the present interim analysis show that the prevalence of GI, cardiac and renal complications among patients is high due to exaggerated usage; however, the final analysis would provide the overall prevalence of these complications.
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Affiliation(s)
| | - Gur Prasad Dureja
- Department of Pain Medicine, New Delhi Pain Management Center, New Delhi, India
| | - Ganesh Kadhe
- Medical Affairs, Wockhardt Limited, Mumbai, India
| | - Amey Mane
- Medical Affairs, Wockhardt Limited, Mumbai, India
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Puppalwar G, Mourya M, Kadhe G, Mane A. Conducting clinical trials in emerging markets of sub-Saharan Africa: review of guidelines and resources for foreign sponsors. OAJCT 2015. [DOI: 10.2147/oajct.s77316] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Mitra M, Shah N, Faridi MMA, Ghosh A, Sankaranarayanan VS, Aggarwal A, Chatterjee S, Bhattacharyya N, Kadhe G, Vishnoi G, Mane A. Long term follow-up study to evaluate immunogenicity and safety of a single dose of live attenuated hepatitis a vaccine in children. Hum Vaccin Immunother 2015; 11:1147-52. [PMID: 26018443 PMCID: PMC4514242 DOI: 10.4161/21645515.2014.979646] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Worldwide, viral hepatitis continues to be a cause of considerable morbidity and mortality. Mass immunization with a single dose of live attenuated HAV has been shown to significantly reduce disease burden in the community. This was a phase IV, 5-year follow up study carried out at 4 centers (Kolkata, Delhi, Mumbai and Chennai) across India. The subjects with antibody titer <20 mIU/mL at baseline were evaluated for long term immunogenicity. Of the 503 subjects enrolled, 349 subjects were baseline seronegative with an anti-HAV antibody titer <20 mIU/mL. Overall, 343 subjects could be followed up at some point of time during this 5 y post vaccination period. In the last year (60 months) of follow-up, 108 subjects (97.3%) of 111 subjects (who came for follow-up at the end of 5 y) had a protective antibody titer (anti-HAV antibody titer >20 mIU/mL). The seroconversion rates considering seroprotection levels of anti-HAV antibody titer >20 mIU/mL, following vaccination starting from 6 weeks, 6 months, 12 months, 24 months, 36 months, 48 months and 60 months were 95.1%, 97.9%, 98.3%, 96.2%, 97.8%, 92.6% and 97.3%, respectively. The geometric mean concentration (GMC) over the years increased from 64.9 mIU/mL at 6 weeks to 38.1 mIU/mL and 135.2 mIU/mL at 6 months and 12 months, respectively and was maintained at 127.1 mIU/mL at 60 months. In conclusion, the result of this 5-year follow up study showed that the single dose of live attenuated vaccine is well tolerated and provides long-term immunogenicity in healthy Indian children.
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Affiliation(s)
- Monjori Mitra
- Institute of Child Health; Kolkata, India
- Correspondence to: Monjori Mitra;
| | - Nitin Shah
- Department of Pediatrics; Lion's Tarachand Bapa Hospital; Sion West, Mumbai, India
| | - MMA Faridi
- Department of Pediatrics; University College of Medical Sciences; GTB Hospital, Dilshad Garden; Delhi, India
| | | | | | - Anju Aggarwal
- Department of Pediatrics; University College of Medical Sciences; GTB Hospital; Delhi, India
| | - Suparna Chatterjee
- Deptartment of Pharmacology; Institute of Postgraduate Medical Education & Research; Kolkata, India
| | | | - Ganesh Kadhe
- Medical Affairs; Wockhardt Limited, Wockhardt Towers; Bandra–Kurla Complex; Bandra–East, Mumbai
| | - Gaurav Vishnoi
- Medical Affairs; Wockhardt Limited, Wockhardt Towers; Bandra–Kurla Complex; Bandra–East, Mumbai
| | - Amey Mane
- Medical Affairs; Wockhardt Limited, Wockhardt Towers; Bandra–Kurla Complex; Bandra–East, Mumbai
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Mitra M, Faridi M, Ghosh A, Shah N, Shah R, Chaterjee S, Narang M, Bhattacharya N, Bhat G, Choudhury H, Kadhe G, Mane A, Roy S. Safety and immunogenicity of single dose live attenuated varicella vaccine (VR 795 Oka strain) in healthy Indian children: a randomized controlled study. Hum Vaccin Immunother 2015; 11:443-9. [PMID: 25692656 PMCID: PMC4514385 DOI: 10.1080/21645515.2014.1004031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Varicella, an acute viral systemic infection that may cause lifelong latent infection with the potential for causing clinical reactivation, may be prevented by immunization. The present study was an open label, randomized, controlled, phase III, multicentre trial, conducted to evaluate and compare the safety, tolerability and immunogenicity of a freeze dried live attenuated Oka strain Varicella Vaccine (VR 795 Oka strain) with Varilrix (Oka-RIT strain) in children. A total of 268 healthy Indian children aged 12 months to 12 y with baseline VZV IgG antibody (<100 mIU/ mL) were enrolled, and 256 children completed the study. The extent of rise of VZV IgG antibody titer assessed as 3-fold and 4-fold rise from baseline was found to be significantly higher (89.1% and 85.2%) in the test group as compared to control group (73.4% and 61.7%). The post-vaccination GMT of the test group was significantly higher (112.5 mIU/mL) as compared with the control group (67.8 mIU/mL) (P < 0.001). The seroconversion rate considering the 5 gp ELISA units/ml equivalent to 10mIU/ml were similar in the control (96.5%) and the test (98.3%) groups. The adverse events were not different in the control and test groups (P > 0.05). The test live attenuated vaccine was found to be highly immunogenic, safe and comparable to Varilrix used in control arm.
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Affiliation(s)
- Monjori Mitra
- Institute of Child Health; Kolkata, India
- Correspondence to: Monjori Mitra;
| | - Mma Faridi
- Department of Pediatrics; University College of Medical Sciences; GTB Hospital Dilshad Garden, Delhi, India
| | | | - Nitin Shah
- Department of Pediatrics; Lion's Tarachand Bapa Hospital Sion West; Mumbai, India
| | - Raju Shah
- Ankur Children's Hospital; Ahmedabad, India
| | - Suparna Chaterjee
- Department of Pharmacology; Institute of Postgraduate Medical Education & Research; Kolkata, India
| | - Manish Narang
- Department of Pediatrics; University College of Medical Sciences; GTB Hospital Dilshad Garden, Delhi, India
| | | | - Gandhali Bhat
- Department of Pediatrics; Lion's Tarachand Bapa Hospital Sion West; Mumbai, India
| | | | | | - Amey Mane
- Medical Affairs Wockhardt; East Mumbai, India
| | - Sucheta Roy
- Medical Affairs Wockhardt; East Mumbai, India
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Narayanan V, Motlekar S, Kadhe G, Bhagat S. Efficacy and safety of nadifloxacin for bacterial skin infections: results from clinical and post-marketing studies. Dermatol Ther (Heidelb) 2014; 4:233-48. [PMID: 25212256 PMCID: PMC4257952 DOI: 10.1007/s13555-014-0062-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Indexed: 01/31/2023] Open
Abstract
Introduction Skin and soft tissue infections involve microbial invasion of the skin and underlying soft tissues and are estimated to affect 7–10% of hospitalized patients worldwide. Nadifloxacin, a topical fluoroquinolone, has been shown to be effective against aerobic Gram-negative, Gram-positive (including MRSA and coagulase-negative staphylococci), and anaerobic bacteria. However, there is paucity of data comparing efficacy and safety of 1% nadifloxacin with other anti-bacterials for skin infections in Indian patients. Methods This article presents the results of one post-marketing surveillance (PMS) and three randomized, open, non-blinded, multi-centric clinical studies that compared nadifloxacin with mupirocin and framycetin, and nadifloxacin with fusidic acid. Patients in India, aged from 1 to 65 years old, suffering from mild to moderate bacterial skin infections including impetigo, secondarily infected wounds, folliculitis, infected atopic dermatitis, and furunculosis were randomly allocated to three treatment groups within the studies. Efficacy was assessed by the evaluation of symptoms of erythema, exudation, swelling, pruritus, crusting, pain and tenderness in all the studies. Results A total of 272 subjects were enrolled in the study and subjects were randomly assigned to one of the three treatment groups; 92 in the nadifloxacin group, 90 in the mupirocin group, and 90 in the framycetin group. A significant reduction in the mean scores for bacterial infection symptoms in the nadifloxacin groups was observed when compared to mupirocin, framycetin and fusidic acid groups. Both physician and patients rated nadifloxacin as excellent (complete remission of symptoms) on a 4-point scale in the studies. No adverse events (AEs) were reported in the clinical studies. In the PMS, only two patients (of 329, 0.6%) reported AEs including burning and itching, one in each patient that had resolved at the time of reporting. Conclusion Nadifloxacin, a fluoroquinolone, is a new alternative topical agent in the treatment of bacterial skin infection with minimal AEs. Electronic supplementary material The online version of this article (doi:10.1007/s13555-014-0062-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Varsha Narayanan
- Wockhardt Ltd., Wockhardt Towers, Bandra Kurla Complex, Mumbai, 400051 India
| | - Salman Motlekar
- Wockhardt Ltd., Wockhardt Towers, Bandra Kurla Complex, Mumbai, 400051 India
| | - Ganesh Kadhe
- Wockhardt Ltd., Wockhardt Towers, Bandra Kurla Complex, Mumbai, 400051 India
| | - Seema Bhagat
- Wockhardt Ltd., Wockhardt Towers, Bandra Kurla Complex, Mumbai, 400051 India
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Shah BJ, Sumathy TK, Dhurat RS, Torsekar RG, Viswanath V, Mukhi JI, Kadhe G, Ahirrao P. Efficacy and tolerability of topical fixed combination of nadifloxacin 1% and adapalene 0.1% in the treatment of mild to moderate acne vulgaris in Indian patients: a multicenter, open-labelled, prospective study. Indian J Dermatol 2014; 59:385-9. [PMID: 25071260 PMCID: PMC4103277 DOI: 10.4103/0019-5154.135492] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: A combination of topical retinoid and antibacterial therapy is often advocated for acne to enhance therapeutic efficacy. Aims: A preliminary study to evaluate the efficacy and tolerability of a topical fixed combination of nadifloxacin (1%) and adapalene (0.1%) in the treatment of mild to moderate acne in Indian patients. Materials and Methods: This was an open-labeled, phase 3 non-randomized, non-comparative study conducted at five centers (Ahmedabad, Nagpur, Thane, Bangalore, and Mumbai) across India. Of 119 enrolled patients with mild to moderate acne, 117 patients were evaluated at the end of the study for efficacy parameters. A fixed combination of nadifloxacin (1%) and adapalene (0.1%) topical gel was applied at the affected area once at night for a period of 8 weeks. Reduction in the total, inflammatory and non-inflammatory lesion counts from the baseline, investigator global assessment (IGA) and reduction in the severity of acne as per combined acne severity classification were the primary efficacy variables measured at 2 weeks, 4 weeks, and 8 weeks. Results: Overall, 98.3% patients showed a statistically significant progressive reduction in non-inflammatory lesion counts, inflammatory lesion counts, and total lesion counts over the study duration. By the end of 8 weeks, 75% of the patients had their global assessment scores approaching to normal healthy skin score. The adverse events were mild to moderate in severity. Conclusion: This preliminary study shows that a fixed combination of 1% nadifloxacin and 0.1% adapalene topical gel could be an effective and well-tolerated option for the treatment of mild to moderate acne vulgaris. However, further well-controlled, randomized and comparative evaluation of this combination is necessary.
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Affiliation(s)
- Bela Jaswantlal Shah
- Department of Dermatology, BJ Medical College and Civil Hospital, Asarwa Ahmedabad, Gujrat, India
| | | | - Rachita Savalaram Dhurat
- Department of Dermatology, Lokmanya Tilak Muncipal General Hospital and Lokmanya Tilak Municipal Medical College, Sion, Mumbai, Maharahstra, India
| | - Raghunandan Govind Torsekar
- Department of Dermatology, Rajiv Gandhi Medical College and Chatrapathi Shivaji Maharaj Hospital, Kalwa, Thane, Maharahstra, India
| | - Vishalakshi Viswanath
- Department of Dermatology, Rajiv Gandhi Medical College and Chatrapathi Shivaji Maharaj Hospital, Kalwa, Thane, Maharahstra, India
| | - Jayesh Ishwardas Mukhi
- Mukhi Skin Clinic, 103 Heera Plaza, Near Telephone Exchange Square, Central Avenue, Nagpur, Maharahstra, India
| | - Ganesh Kadhe
- Medical Affairs Department, Wockhardt Ltd, Wockhardt Towers, Bandra Kurla Complex, Mumbai, Maharahstra, India
| | - Pashmina Ahirrao
- Medical Affairs Department, Wockhardt Ltd, Wockhardt Towers, Bandra Kurla Complex, Mumbai, Maharahstra, India
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KrupaShankar DSR, Somani VK, Kohli M, Sharad J, Ganjoo A, Kandhari S, Mysore VR, Aurangabadkar S, Malakar S, Vedamurthy M, Kadhe G, Motlekar S, Ahirrao P. A cross-sectional, multicentric clinico-epidemiological study of melasma in India. Dermatol Ther (Heidelb) 2014; 4:71-81. [PMID: 24643868 PMCID: PMC4065278 DOI: 10.1007/s13555-014-0046-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Indexed: 11/25/2022] Open
Abstract
Background Melasma is one of the most common pigment disorders seen by a dermatologist and often occurs among women with darker complexion (skin type IV–VI). Aims The present study aimed to investigate the epidemiology of melasma in the Indian population and to focus on the regional variability in the demographics, clinical manifestations and factors that precipitate this condition. Methods The present multicentric study conducted across four regions in India enrolled patients (>18 years) diagnosed with melasma on Wood’s light examination. Patients were examined to identify the distribution of melasma. Various precipitating and etiological factors for melasma were documented. Results The mean age of the 331 enrolled patients with melasma was 37.2 ± 9.3 years. The prevalence of melasma was higher in females with a female to male ratio of approximately 4:1. The overall population with family history was 31%, highest in the northern region (38.5%) and lowest in the eastern region (18.2%). The two prominent patterns of distribution were centrofacial (42%) and malar (39%). Only 35% of the patients were using sunscreens. Of these, 10% of the patients used sunscreen with SPF >50. The usage of sunscreens was observed to be highest in the north (69%). About 51% of women with multiple pregnancies had a history of melasma when compared with single women (25%) or with no pregnancy (24%). Conclusions In conclusion, the result of the study showed that there was a regional variability in the demographics, clinical manifestations and factors that precipitate melasma among patients in India. There was a strong correlation between the family history and prevalence of melasma. Sun exposure is a major precipitating factor in melasma, but only 10% of the patients used sunscreen with SPF >50. Other factors such as concomitant medication, chronicity of disease, multiple pregnancies and use of oral contraceptives might precipitate melasma. Electronic supplementary material The online version of this article (doi:10.1007/s13555-014-0046-1) contains supplementary material, which is available to authorized users.
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14
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Mitra M, Arankalle V, Bhave S, Ghosh A, Balasubramanian S, Chitkara A, Choudhury J, Chatterjee S, Kadhe G, Mane A, Roy S. Changing epidemiology of hepatitis A virus in Indian children. ACTA ACUST UNITED AC 2014. [DOI: 10.2147/vdt.s53324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Dureja GP, Jain PN, Shetty N, Mandal SP, Prabhoo R, Joshi M, Goswami S, Natarajan KB, Iyer R, Tanna DD, Ghosh P, Saxena A, Kadhe G, Phansalkar AA. Prevalence of Chronic Pain, Impact on Daily Life, and Treatment Practices in India. Pain Pract 2013; 14:E51-62. [DOI: 10.1111/papr.12132] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 09/15/2013] [Indexed: 01/07/2023]
Affiliation(s)
- Gur Prasad Dureja
- Department of Pain Medicine; New Delhi Pain Management Centre; New Delhi India
| | - Paramanand N. Jain
- Department of Anesthesiology, Critical Care & Pain; Tata Memorial Hospital; Mumbai India
| | - Naresh Shetty
- Department of Orthopedics; M.S. Ramaiah Medical College and Hospitals; Bengaluru India
| | | | - Ram Prabhoo
- Department of Orthopedic Surgery; Mukund Hospital; Mumbai India
| | - Muralidhar Joshi
- Department of Pain Management; Kamineni Hospitals; Hyderabad India
| | - Subrata Goswami
- Department of Pain Management; ESI Hospital Sealdah; Kolkata India
| | | | - Rajagopalan Iyer
- Department of Orthopedics; Indira Gandhi Medical College & Research Institute; Pondicherry India
| | - D. D. Tanna
- Department of Orthopedic Surgery; Jaslok Hospital; Mumbai India
| | - Pahari Ghosh
- Department of Neurology; Ramakrishna Mission Seva Pratisthan; Kolkata India
| | - Ashok Saxena
- University Medical College; University of Delhi; New Delhi India
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Vaidya S, Walwaikar P, Kadhe G. Evaluation of anti-atherosclerotic and vasculoprotective effect of long acting nifedipine in patients after PTCA. J Indian Med Assoc 2001; 99:519-20, 522. [PMID: 12018562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The anti-atherosclerotic and vasculoprotective effect of long acting nifedipine (nicardia retard 20) was evaluated on patients undergoing percutaneous transluminal coronary angioplasty (PTCA). This was a randomised, controlled, prospective clinical trial. A total of 30 patients fulfilling inclusion criteria were divided randomly in 2 groups of 15 each. One group was given long acting nifedipine while other group did not receive long acting nifedipine. The rest of the treatment was similar for both the groups. Clinical and angiographic parameters were evaluated regularly for a period of one year. The group receiving long acting nifedipine showed 20% restenosis as against 33% in group not receiving long acting nifedipine. Thus, from this trial, it can be concluded that long acting nifedipine can reduce the progress of reocclusion and thus demonstrates the anti-atherosclerotic and vasculoprotective action.
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Affiliation(s)
- S Vaidya
- Grant Medical College & JJ Group of Hospitals, Mumbai
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