Girish Thunga

Manipal Academy of Higher Education | MAHE · Department of Pharmacy Practice

Problem considered: Coronavirus disease(COVID-19) outbroke towards the end of December 2019 in China, soon it started spreading rapidly to various countries leading to an outburst of pandemic. Due to the restrictions imposed to control the spread of the infection, globally the manufacturing, import and export of medicine and the healthcare service...

Background and aim: Inappropriate use of antibiotics may increase antimicrobial resistance (AMR) among different microorganisms and may lead to treatment failure in neonatal septicemia. The aim of this study was to recognize the most common microorganisms responsible for neonatal sepsis and to evaluate the trend of change of resistance pattern amo...

Background: The World Health Organization estimates that there are approximately 5.4 million snakebites and 1.8-2.7 million cases of envenomation, with 81 410-137 880 deaths each year worldwide. Aims: To estimate the prevalence of neurotoxic and haemotoxic snakebite envenomation through a comprehensive systematic review and meta-analysis. Metho...

Background: According to the World Health Organization, globally, there are ~5.4 million snake bites and 1.8–2.7 million cases of envenomation, with 81 410–137 880 deaths annually. Aims: To estimate using a comprehensive systematic review and meta-analysis the prevalence of neurotoxic and haemotoxic snake bite envenomation. Methods: Medline/PubMed,...

Background and objective: Proton Pump Inhibitors (PPIs) reduce gastric acid production and they are indicated for myriad gastrointestinal conditions. Prolonged use of PPI has been linked to the risk of inflammatory bowel disease (IBD) though this fact is not well established. We aimed to conduct a systematic review and meta-analysis to estimate th...

Background: Guillain Barre syndrome (GBS) is a rare autoimmune neurological disorder resulting in variable clinical course and outcome. Various factors such as age, symptoms and disease form that influence the outcome of GBS have been previously studied. Aim: This study aimed at identifying factors affecting the outcomes in patients with GBS. M...

Background and objective Wrong labeling of the drugs is one of the critical issues that can end up in serious health issues among patients. Labeling errors of high-risk medications can lead to permanent disability or death of patients in critical settings. This article aims in identifying and analyzing the critical labeling error of the parenteral...

Purpose : Antiepileptic drugs (AEDs) are extensively used to manage epilepsy and other comorbidities associated with seizures. Human Leukocyte Antigen (HLA) has a strong association with AED-induced severe cutaneous adverse drug reactions. Objective : We aimed to perform a systematic review and meta-analysis to identify, critically evaluate, and s...

Background and aim: Risk factor-based approach is one of the best approaches employed by middle income countries which are not well facility driven for any disease management. Thus, through this approach, we aim to identify the potential risk factors responsible for the poor outcome in neonatal sepsis. Methods: A case control was conducted retro...

Background and objective Acute respiratory distress syndrome (ARDS) is a life-threatening pulmonary disease with a high clinical and cost burden across the globe. Artificial intelligence (AI), an emerging area, has been used for various purposes in ARDS. We aim to summarize the currently available literature on various applications of AI in ARDS th...

Background and objective Differentiating tropical infections are difficult due to its homogenous nature of clinical and laboratorial presentations among them. Sophisticated differential tests and prediction tools are better ways to tackle this issue. Here, we aimed to develop a clinician assisted decision making tool to differentiate the common tro...

Introduction: Vaccines are the best tools to end the pandemic, and their public acceptance is crucial in achieving herd immunity. Despite global efforts to increase access to vaccination, the World Health Organization explicitly lists vaccination hesitancy (VH) as a significant threat. Despite robust safety reports from regulatory authorities and...

Background and aims: Prompt recognition and optimal management of hyponatremia helps the physician devise a better treatment plan to prevent future complications in patients. Hence this study aims to identify the risk factors associated with hyponatremia in psychiatric patients. Methods: A case-control study was conducted among psychiatric inpat...

Background Drug-drug interactions are highly prevalent in chronic kidney disease (CKD) patients, owing to the progressive deterioration in renal function, existence of various comorbidities, and use of multiple drugs to treat them. Aim To evaluate the number and types of potential drug-drug interactions (pDDIs) observed in the study population and...

BACKGROUND AND AIMS The risk of developing tuberculosis (TB) is 10–25% in chronic kidney disease (CKD) patients. TB in CKD patients may have a mortality of 16–37%. Standard treatment with four drugs (Isoniazid, Rifampin, Pyrazinamide and Ethambutol) predisposes to side effects, drug interactions and incomplete adherence in this population. We studi...

What is known and objective: The effect of histamine-2 receptor antagonists (H2RAs) use causing inflammatory bowel diseases (IBD) has been reported in few isolated observational studies; however, pooled estimation of IBD risk has not been done. The present study was conducted to estimate the risk of IBD [Crohn's disease (CD), ulcerative colitis (U...

Objective This review evaluates the effectiveness of smartphone applications in improving academic performance and clinical practice among healthcare professionals and students. Methods This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were retrieved from PubMed, Scopus, and Co...

Introduction Patients with severe mental illness (SMI) have poor physical wellbeing, leading essentially shorter lives, compared with the general population. Routine metabolic monitoring is proposed as a strategy for recognizing risk factors for metabolic variations in this population. This narrative review aimed to identify interventions at enhanc...

Background COVID-19 has become extremely dangerous manifesting itself in a variety of forms ranging from a simple flu-like illness to death. COVID-19 associated mucormycosis (CAM) is a global threat with diabetes being a major contributor. . Objective This review aims to give a clear picture of the impact of hyperglycemia in CAM along with its man...

Background and aim The importance of glucagon-like peptide-1 (GLP-1) agonists is increasing because of its blood sugar controlling and weight loss properties. The data regarding safety of GLP-1 agonists are limited. This study aims to review case reports and case series on adverse drug reactions (ADRs) of GLP-1 agonist. Methodology A comprehensive...

Purpose The clinical profile and factors affecting outcomes in acute respiratory distress syndrome (ARDS) from adequately sample-sized Indian studies are still lacking. We aimed to investigate the clinical profile, treatment pattern, outcomes; and to assess factors affecting non-recovery in ARDS patients. Patients and methods A retrospective obser...

Background &objectivesThough there are studies to evaluate the effectiveness of blended learning in pharmacy education, most of them originate from USA and have used previous year students' scores as control. Also there is less research in comparing use of self -regulated learning strategies between blended and other learning strategies. Primary ai...

Background: Treatment with N-Acetyl cysteine (NAC) in rodenticide poisoning has not been well established due to mixed study results and insufficient evidence. This review aimed to summarize the clinical benefits of NAC in the management of rodenticide poisoning. Method: This review follows the PICOS framework and the PRISMA guidelines. PubMed/M...

Background Evidence-based recommendations on efficacy and safety of corticosteroids in acute respiratory distress syndrome (ARDS) remains a therapeutic challenge. Findings from several systematic reviews and meta-analyses are inconsistent. We aimed to assess the published meta-analyses through a systematic review approach and provide further insigh...

Background & objective Though blended learning (BL), is widely adopted in higher education, evaluating effectiveness of BL is difficult because the components of BL can be extremely heterogeneous. Purpose of this study was to evaluate the effectiveness of BL in improving knowledge and skill in pharmacy education. Methods PubMed/MEDLINE, Scopus and...

Paraquat poisoning is a major medical problem in many parts of Asia, Pacific nations, and America. An increased rate of morbidity and mortality is associated with paraquat poisoning due to the absence of a definite antidote. The objective of this study is to assess the effectiveness of various treatment strategies with the outcome in paraquat poiso...

Background: Inappropriate medication use poses a sizable health safety hazard in the elderly owing to aging-associated physiological and anatomic changes. Inappropriate drug prescribing and polypharmacy in this population elevates the risk of adverse drug reactions (ADR). To assess the prevalence and predictors of Potentially Inappropriate Medicat...

Introduction: Any defects in pharmaceutical products lead to minor, major, or critical deviation and if such a product is released, it also leads to product recalls and legal actions. In such cases, the concern is about patient's safety rather than the company's economy and fame. This study aimed to investigate the various quality defects which hav...

Mobile applications allow communications and access of information processing even at the patient’s bedside. We aimed to evaluate the effectiveness of smart phone based applications in improving academic performance and clinical practice among all healthcare professionals.

Introduction The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people worldwide and has contributed to over 650,000 deaths. This review synthesizes the literature on COVID-19 pharmacotherapy to inform practice and policymaking. Areas covered The authors syste...

The objectives of this study were to identify the risk factors for metabolic syndrome in patients on antipsychotics and to compare the frequency of metabolic monitoring with evidence-based guidelines. We conducted a retrospective cohort study in a tertiary care health institution of South India. The study included patients with schizophrenia, bipol...

OBJECTIVE: The aim of the study was to assess the perception of final year pharma students, faculties from various Pharmacy Council of India/All India Council for Technical Education approved pharmacy colleges and industrial experts toward skill gaps, employability, and job-oriented training programs. METHODS: Cross-sectional survey conducted usin...

Rationale & Objective Rodenticide poisoning, either accidental or intentional, is very common in rural India. Absence of a definite antidote made it a major concern with a high mortality rate. So, we aimed to assess the effectiveness of N-Acetyl Cysteine (NAC) in rodenticide poisoning as there are recent positive shreds of evidence on it. Methodol...

World Health Organization recommends doctor population ratio as 1: 1000 and in India the ratio is 0.62: 1000. With the ever growing population and tremendous patient pool in India the significant challenge faced by clinicians is lack of skilled allied health professionals who can assist in providing timely, unbiased, critically appraised health inf...

Organophosphate and carbamate (OPC) poisoning is a major global health hazard requiring immediate medical intervention. Atropine (ATR) is an essential antidote in organophosphate and carbamate poisoning, with the inclusion of cholinesterase reactivators and other anticholinergics, namely pralidoxime (PAM) and glycopyrrolate (GPR). This study aimed...

Objective: The objective of this study was to determine the association between antihypertensive drug use and new-onset diabetes (NOD) in patients with hypertension (HTN). Materials and methods: A retrospective observational study was conducted in a tertiary care hospital located in south India. Patients diagnosed with HTN and HTN with diabetes...

Acute poisoning is a serious health problem that is associated with high mortality. Management of acute poisoning cases in the critical care settings is the biggest challenge due to the difficulty in identification of poison involved. Immediate information about the poisoning and its management is crucial in the early diagnosis, treatment, and in t...

Introduction: The main aim of this project was to study the patient information leaflets (PIL), primary labels (PL) and primary cartons for their adequacy, harmonization of printed text matter meeting regulatory requirements. Methods: The study involved comparative evaluation of PIL, PL and primary cartons of generic and innovator brands. Three dif...

Background and Aim Treatment outcomes in bipolar disorder are highly variable, and several sociodemographic, clinical characteristics, and comorbidities play an important role. Early recognition of these factors will help the physicians to implement individualized treatment and a better clinical outcome. The present study was aimed at identifying t...

Background Sepsis is a complex condition defined by the systemic response to infection. Severity assessment scoring systems are used to aid the physician in deciding whether aggressive treatment is needed or not. In this study, various severity assessment scoring systems, namely Acute Physiology and Chronic Health Evaluation II (APACHE II), Rapid E...

The objective of this study was to assess the impact of implemented periodic safety update report (PSUR) system in our hospital via PSUR function assessment questionnaire (PFAQ) vetted by Delphi panel and by comparing frequency and rate of adverse drug reaction (ADR) reporting for three highly prescribed drugs. An PFAQ was validated by Delphi panel...

Though Pharmaceutical industries are growing at a rapid rate, Pharmacy curriculum is not taken pharmaceutical industry into consideration. Both industry and academia have different mindsets and goals. Pharma curriculum is mainly oriented towards the conventional needs of an industry which inturn creates a gap between industry and academia. Pharma g...

Objectives Inadequate glycemic control amongst patients with Type 2 diabetes mellitus (T2DM) indicates a major public health problem and a significant risk factor for the progression and complications caused by diabetes. Glycemic control is the main therapeutic objective for the prevention of organ damage and other complications arising from diabet...

Objectives With two decades of introduction of Pharmacy Practice education and a decade of Pharm D program in India, there has been a paradigm shift in the practice of evidence-based clinical pharmacy/pharmacology in the country. Wide variation exists in the requirement of teaching evidence based medicine/evidence based practice (EBP) across health...

Aims Evaluation of supportive care management of cancer patients experiencing drug-related problems (DRPs) is a challenge because it might increase the cost due to additional therapy. The main objectives of this study were to estimate chemotherapy-associated drug-related hospital admissions in the department of medical oncology and to estimate the...

Objective: Denguefeveris one of the important tropical disease of public health significance caused by flavivirus. It is a major cause of morbidity and mortality worldwide. Identification of factors associated with severity of dengue can improve the prognosis of the disease.This study tried toassess the factors associated with severity of dengue.Me...

A patient information leaflet is an educational material for educating patients regarding a disease, medications and lifestyle modifications for better care. The present study aimed at preparing, validating and user-testing of diabetes and hypertension information leaflets in different languages among patients. The patient information leaflets on d...

Background: Diabetes mellitus is a major public-health related problem. The increase in prevalence rates has led to an increase in the economic burden, worldwide. To manage the disease in a better way, Drug utilization research can be used as a strategy to justify the drug therapy. Aims: To study the drug prescribing pattern of anti-diabetic drugs...

Introduction: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder. Its expression is greatly influenced by the combined effect of genetic, environmental, demographic and geographical factors. The treatment is highly individualized depending on the development of clinical features. Objective: To study the treatment pattern and di...

Background: Severity or mortality prediction of nosocomial pneumonia could aid in the effective triage of patients and assisting physicians. Aim: To compare various severity assessment scoring systems for predicting intensive care unit (ICU) mortality in nosocomial pneumonia patients. Methods: A prospective cohort study was conducted in a tert...

Background: H1N1 (hemagglutinin-H-neuroaminidase-N) influenza infection is associated with high morbidity and mortality because of associated complications and related factors. Predictors of mortality in H1N1 patients are studied with very few without seasonal/pandemic declaration. This study was carried out to describe the clinical features, comp...

Background: Deficits in the treatment options makes Acute Respiratory Distress Syndrome (ARDS) management more challenging. With Involvement of inflammatory pathways, corticosteroid remains a vital choice for ARDS treatment. However lack of studies and presence of ambiguity in results with use of glucocorticoids makes it imperative to carry out mor...

Objectives Nosocomial pneumonia is a common infection occurring in intensive care units. Scores to predict probability or risk of mortality in nosocomial pneumonia are lacking. The objective of this study was to develop a mortality prediction tool in nosocomial pneumonia patients and compare it with APACHE II taken as a standard. Methods The tool...

Organophosphate (OP) and mixed pesticide poisoning remains an important cause of hospital admission. Therefore, physician must be aware of atypical presentations of delayed neurological complications of poisoning by taking proper patient history. We report a case of a 23-year-old female who presented with high stepping gait and muscle wasting in ha...

Objective: To evaluate the drug utilization pattern of anti-diabetic agents with respect to glycosylated hemoglobin A1c (HbA1c) level in a Type 2 diabetes patient with complication. Methods: This retrospective observational study was conducted as per the protocol approved by the Institutional Ethics Committee. The patients diagnosed with Type 2 dia...

Objective: To identify and evaluate medication errors, opportunities like medication documentation errors and possible drug-drug interactions by a clinical pharmacist, in general, medicine wards of the South-Indian tertiary care hospital. Methods: A study was conducted for a period of 6-month. The data were collected by chart review method from the...

We describe a 43 year old lady who presented with features of acute abdomen and jaundice. During the course of her illness, her clinical status worsened until serology confirmed antibodies to Orientiatsutsugamushi. A diagnosis of Scrub typhus was reached and doxycycline was initiated which led to an uneventful recovery. In endemic areas, patients p...