Dry cough which is excessive and often troublesome needs to be suppressed in order to improve the quality of life and prevent the complications of excessive cough. This talk dicusses the role of various antitussives in the management cough and the dual mode of action of the non opioid antitussive- Noscapine.

Cough is a common symptom of Respiratory tract infection (RTI) in children. This cough mostly dry in nature and management of the same is very crucial.This talk discusses about the advantages and disadvantages of non opioid antitussives in suppressing the acute dry cough associated with RTI in children

Dehydration is a serious issue worldwide caused by excessive loss of body water. Fluid is lost through sweat, tears, vomiting, frequent urination, or diarrhoea. WHO and UNICEF have recommended single formulation of ORS (Oral Rehydration Solution) to prevent or treat dehydration from diarrhoea irrespective of the cause or age group affected.

Diabetes and its complications, if not well managed, can lead to frequent hospitalisations and premature death. Strict glycaemic control over long term is the mainstay of diabetic neuropathy management, however, it does not reduce or halt the progression of diabetic neuropathy.

Constipation is a chronic condition that affects approximately 16% of the adults worldwide. BMI ≥ 35 kg/m2, or classes II and III, increase the risk of chronic diseases and mortality. Although obesity has been linked to constipation, it is not recognised as a cause of constipation, but they have been found to share risk factors

Antibiotic Stewardship Program plays a crucial role in combating antimicrobial resistance (AMR). Implementing the best strategic approach, proper utilisation of available tools, strict adherence to the infection control practices, and judicious use of antibiotics can help in fighting the evil of the AMR.

Functional gastrointestinal disorders (FGIDs) are widespread. Most common FGIDs encountered in gastroenterology practice are functional dyspepsia & irritable bowel syndrome. Digestive enzymes have shown significant improvement in symptoms caused by FD & IBD which include abdominal pain, bloating, early satiety, fullness, belching, & nausea.

Poor child growth is a global health concern. Zinc plays an important role in growth and development. About 17% of the world’s population is at the risk of zinc deficiency. Zinc participates in cell division, intestinal electrolyte absorption, neurotransmission, immune response, enzymatic catalysis, and functional modification of proteins.

Transitioning from intravenous to oral antibiotics is advantageous, prior to which it needs to be made sure if the antibiotic shows a good clinical stability in the patient, control of disease progression, & patient should feel symptomatically better. Concentration of the oral antibiotic, bioavailability, & pharmacokinetics play an important role.

Micronutrients are beneficial for the management of COVID-19 as they help boost the immune health. Choosing a multivitamin with the right amount of Se and Lyc not only improves the immune response, but also enhances the recovery.

The World Health Organization strongly suggests a specific formula for Oral Rehydration Solution (ORS) in pediatrics. This crucial formula, containing the right mix of sodium and glucose, addresses dehydration in children, especially due to issues like diarrhea and its complications. Endorsed by WHO, this formula is a straightforward and essential intervention, emphasizing the global commitment to pediatric health by providing a standardized and effective solution for dehydration management in children.

Cefpodoxime, a third-generation cephalosporin, is a potent antibiotic renowned for its efficacy in managing respiratory tract infections. Distinguished by broad-spectrum activity and stability against beta-lactamases, it outperforms alternatives such as penicillin. Widely recommended by guidelines, its favorable dosing regimen and robust tissue penetration underscore its status as a valuable therapeutic option for respiratory infections

Cefuroxime, a second-generation cephalosporin, serves as a valuable option for empirical therapy in urinary tract infections (UTIs). The management of UTIs involves swift antibiotic administration and prudent selection, considering patient response and culture results. In cases of severe symptoms or localized antibiotic resistance, empiric broad-spectrum antibiotics become essential. Cefuroxime stands out in this context, offering extensive coverage, elevated urinary concentration, and a proven track record of effectiveness and safety for UTI treatment. This antibiotic is a go-to option for empirical therapy in UTI management.

Antacids and proton pump inhibitors (PPIs) are important for managing chronic cough linked to Gastroesophageal Reflux Disease (GERD). They work by reducing stomach acid and irritation in the airways, improving symptoms and quality of life. Learn how these treatments control acid and help relieve GERD-related chronic cough, providing relief for those affected.

In India, up to 90% of elderly individuals exhibit Vitamin B12 deficiency, linked to inadequate intake and absorption issues. This deficiency can lead to diverse health concerns, including cardiovascular issues, Alzheimer's disease, depression, and osteoporosis. Factors like metformin usage in diabetes exacerbate deficiency risks. Timely screening and supplementation are crucial to address Vitamin B12 deficiency and its associated health risks effectively.

Allergic Rhinitis is the one of the most common chronic condition worldwide caused by Immunoglobulin E (IgE) mediated reactions to inhaled allergens This infographic consist – Classification, Diagnosis, Differential Diagnosis and Treatment of Allergic Rhinitis

Clinical presentation of Gastritis is not well defined and the definite diagnosis is only based on histological examination of the gastric mucosa The infographic consist – Classification, Types and differential diagnosis and treatment of gastritis

Constipation is a very common symptom that affects most people some time in their life. For some it can be chronic, at times severe, and can have significant and even debilitating effect on the quality of life. From a patient’s perspective it may not just be the objective observation of infrequent bowel movements, but also the subjective complaints The infographic consist of – Diagnostic approach, Symptoms, Diagnostic Algorithm of Constipation

Anaemia is a condition wherein body’s tissue do not receive adequate oxygen due to lack of healthy red blood cell This infographic consist: Evaluation of Low haemoglobin level, Normocytic anaemia, Macrocytic anaemia and treatment of Anaemia

Dyspepsia is episodic or persistent upper abdominal pain often associated with bloating, heartburn, belching, nausea and vomiting This infographics consist: Causes, Alarm features, Evaluation and Management of Dyspepsia

Vitamin B12 deficiency is common amongst elderly, pregnant women and vegans. The diagnosis of B12 deficiency is not always straightforward because the symptoms and signs are non-specific, mainly in the early stages This infographic consist of: Physical examination, Clinical manifestation, Symptom, Diagnosis and Management of Vitamin B12 deficiency

Acute low back pain is a pain that extends from the lowest rib to the buttocks and sometimes even the lower limbs. The pain is acute, generally felt on either side of the midline and lasts up to six weeks This infographic consist of: Differential Diagnosis and Management of Acute low back pain

Neisseria gonorrheae, an obligate human pathogen, is a sexually transmitted disease that causes consequential morbidity globally.1,2 N. gonorrheae commonly affects the urogenital tract of adults, but also causes anorectal, conjunctival, and pharyngeal infections This infographic consist: Symptoms, Clinical manifestation, Differential Diagnosis and treatment of Gonorrheae

Urinary tract infections (UTIs) are the most common bacterial infections occurring in males and with a higher prevalence in females. Some cases of uncomplicated UTIs resolve without treatment, but some patients seek therapy for relieving their symptoms This infographics consist: Symptoms, Differential diagnosis, Diagnosis, Types and Treatment options of Urinary tract infections

Vitamin D plays a critical role in calcium homeostasis and bone metabolism. Even with mild chronic vitamin D deficiency, patients can experience symptoms related with secondary hyperparathyroidism including bone pain, arthralgias, myalgias, fatigue, muscle twitching, and weakness This infographic consist: Symptoms, Risk factors, Differential Diagnosis, Diagnosis and Treatment of Vitamin D deficiency

Anaemia affects 1/3rd of the world’s population it affects - 59% children <5 years , 53% women aged 15-49 years and 50% pregnant women This infographic consists of: Symptoms, Diagnosis and Differential Diagnosis

Acid reflux is a common problem in India, with a prevalence of about 10% and is rising owing to lifestyle changes and increasing obesity This infographic consist: Prevalence, overview, Clinical evidence and Treatment of Acid reflux

GERD is a common digestive condition that develops when there is a retrograde flow of stomach contents back into the esophagus

Cough is one of the most common medical complaints accounting for over 30 million clinical visits every year. It is categorised based on its duration as acute, sub-acute and chronic

Dehydration is a complex condition resulting in a reduction in total body water. In most cases, dehydration is due to conditions such as diarrhea, excessive vomiting, uncontrolled diabetes, chronic kidney disease and/or the effects of medication and not due to lack of access to water

COPD is characterized by progressive airflow limitation that is not fully reversible and tissue destruction due to chronic inflammation from prolonged exposure to noxious irritants.

Cellulitis refers to an acute infection of the skin involving the dermis and subcutaneous tissues. It typically presents as a poorly demarcated, warm, erythematous area with associated edema and tenderness to palpation.

Hepatitis manifests as an acute or chronic liver disease that may cause mild or severe hepatic damage

Any discontinuation in the inner lining of the gastrointestinal (GI) tract extending into the muscularis propria layer of the gastric epithelium is known as Peptic Ulcer

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by altered bowel habits in association with abdominal discomfort or pain, in the absence of detectable structural and biochemical abnormalities

Respiratory Tract Infections (RTI) classified into two types: Upper RTI and Lower RTI. URTI is considered as the topmost communicable disease worldwide. Viral and Bacterial RTI are most common followed by fungal infection.

Vitamin B12 is an essential cofactor for enzymes such as methionine synthase and methylmalonyl-CoA

There is always scope for improvement in every practice and the same holds good for clinical practice. The two key factors for a successful clinical practice are retaining existing patients and adding new patients.

Doctors experience an array of mental health issues. Studies report 80% of doctors are at high/very high risk of burnout. Junior doctors are most at risk followed by GPs. It is vital for them to assess their own well-being and adopt simple strategies to live a more balanced and fulfilled life through self-care.

Healthcare professionals like you are frequently burdened with relentless work and complex cases while on duty, causing stress and fatigue. It is important to take on a personal responsibility to be aware of key issues of work related muscle and joint pains or discomfort and adopt ergonomic preventive measures to maintain consistency, excellence, career longevity and over all well-being.

Ethical issues in healthcare are complex and sometimes even the right decision might not feel like the most ethical approach. Understanding the various ethical challenges in healthcare can empower you to make smart decisions that are better for patients.

The mission of pharmacy practice is to provide medications and other healthcare products and services and to help people and society to make the best use of them. 

The World Gastroenterology Organization guidelines recommend antacids as appropriate OTC treatment options for infrequent, mild, or moderate symptoms of heartburn.

Tetanus is a vaccine-preventable disease with distinctive symptoms. However,in India, it persists as a public health concern. Early diagnosis, immediate wound care, public awareness and adult immunization are vital for eliminating adult tetanus in India.

The studies provide strong evidence for Ambroxol's efficacy and safety as a non-prescription therapy for children with respiratory diseases. It's favorable benefit/risk profile extends across all age groups, including neonates, with acute and chronic respiratory conditions.

Gastroparesis is a gastrointestinal manifestation of diabetic autonomic neuropathy.

GERD is diagnosed by upper GI endoscopy, response to acid suppression, and esophageal pH monitoring.

Factors causing recurrent aphthous ulcers are common & systemic infections, & nutritional deficiency.

Diarrheal illness is classified as acute watery, invasive (dysentery), or persistent diarrhea.

Anaemia in children can be caused due to infections, haemoglobinopathies, and nutritional deficiency.

Globally, the most common cause for maternal anaemia in pregnancy is Iron Deficiency Anaemia (IDA).

The main causes of dry cough are viral infection, allergies (exposure to irritants), and asthma.

The causes of productive cough are acute bronchitis, pneumonia, and exacerbation of chronic bronchitis.

Classification of allergic rhinitis is based on symptom duration and severity.

Urinary Tract Infections (UTIs) are among the most widespread infections in clinical practice worldwide. With over 8.3 million clinic visits and more than 1 million hospitalizations, cases of UTI are both morbid and recurrent. A single type of bacteria, for example, E.coli causes about 80-90% of UTIs.

UTIs are more common in women than men. Around 50% of women experience Urinary tract infections (UTI) at some point in their lives which has been a growing cause of concern.1
Even though the prevalence data shows that the occurrence of UTI is most likely between the ages of 14 and 24, both men and women of older ages experience episodes of uncomplicated UTIs just as much. In men, symptomatic UTIs are less common with 12% prevalence rates.2

Pneumonia is a form of acute lower respiratory infection. It is characterized by the deposition of fluid and/or pus in the alveoli, limiting oxygen exchange and making breathing painful and difficult.
Pneumonia is usually caused by viruses or bacteria and rarely by other microorganisms. It is the leading cause of death, especially in children below the age of 5 and adults over 65.1 There are over 30 different causes of pneumonia and are grouped as bacterial pneumonia, viral pneumonia, fungal pneumonia, and other pneumonia. They can also be categorized as community-acquired, hospital-acquired, or aspiration pneumonia.2

Pneumonia affects approximately 450 million people worldwide and leads to 4 million deaths each year. India accounts for over 23% of the global pneumonia burden. With over 30 million new cases of childhood pneumonia reported each year, India tops the list of countries with a high disease burden.3

Gastroesophageal reflux disease (GERD) is a common gastrointestinal condition occurring due to the retrograde flow of refluxate from the stomach into the esophagus. The most typical symptoms in GERD are regurgitation and heartburn. Gastro-esophageal refluxate contains a variety of noxious agents, mainly acid but also pancreatic enzymes, pepsin and bile salts. Exposure of the esophageal mucosa to these agents may result in critical injuries to the delicate structures, resulting in reflux esophagitis, esophageal stricture, Barrett’s esophagus, esophageal adenocarcinoma and others.
Even though GERD is a very common clinical diagnosis, its pathogenesis is quite complicated. In many cases, this is due to inappropriate lower esophageal sphincter (LES) function. The pathogenesis of GERD involves an interplay of neurological, chemical, mechanical and psychological mechanisms, which contribute to symptom presentation and influence diagnosis and treatment. Owing to the multifactorial development, many patients may continue to experience detrimental symptoms due to GERD, despite prolonged acid suppression with proton pump inhibitor therapy.1

Allergic rhinitis is one of the most common allergic diseases worldwide, affecting about 10-25% of the global population. It continues to be one of the top ten reasons for a visit to a primary care physician.

In India, the burden of allergic rhinitis has seen an exponential rise over the past few decades. The current estimates suggest that at least 20-30% population in India suffers from allergic rhinitis.1

Functional constipation is a fairly common problem occurring in childhood. It has a varied prevalence between geographic regions. In North and South America, the prevalence (including infants–adolescents) ranges between 10% and 23% respectively, while in Europe (only including children) numbers between 0.7% and 12% are reported. In Asia (including infants– dolescents), the prevalence is estimated between 0.5% and 29.6%.
The prevalence also varies according to different age groups. The peak incidence of constipation has been reported between 2 and 4 years of age, when the potty training of a child starts. A recent systematic review found that the median prevalence of constipation in children was 12%. The incidence of constipation reported in infants varies between 0.05% and 39.3%, but based on expert consensus the prevalence is estimated at 15%.1

Emerging evidence indicates that the early life nutritional intake of a child is directly linked to their neurocognitive development. It is said that the first 1000 days of life represent the most crucial stage of neurodevelopment as maximum nervous system development occurs in this period. However, the central and peripheral nervous systems continue to develop and change all through life.
Nutrition plays a key role in modulating neurodevelopment. It is known that acute and chronic malnutrition can impair cognitive development and is more likely to lead to low IQ, attention, and behavioural problems.1 Observational studies indicate that chronic malnutrition may cause stunted growth and deficits in cognition and academic achievements in children from the age of 5 to adolescence.2 On the contrary, optimal nutrition can improve cognitive outcomes. A study has found that consuming a protein-rich diet and energy drinks showed higher cognitive scores at age 4-5, better vocabulary at age 11-18, improved reading capabilities and IQ scores at age 22-29 and a 46% increase in their average wages later in life (age 26-42) as compared to children who did not consume such diet.

Functional abdominal bloating and distention (FABD) is one of the most commonly reported gastric issues to physicians. FABD may be thought of as a sole complaint or may coexist with other functional gastrointestinal disorders such as functional dyspepsia, irritable bowel syndrome, and functional constipation.
Bloating can be defined as a sense of gassiness or a sense of being distended; measurable distention does not have to occur, whereas abdominal distention should be reserved for patients who show a visible increase in abdominal girth.
About 30% of the general adult population report bloating and distention along with IBS. However, half of the people with bloating also report abdominal distention.1 It is noted that bloating is common among patients with IBS, whereas distention is more common in patients with chronic constipation.2

Gastrointestinal discomfort is a very common complaint in pregnancy. In fact, most pregnant women will experience at least one GI discomfort like nausea, vomiting, GERD, etc., throughout their pregnancy.
While these conditions do occur in men and non-pregnant women, they occur more frequently during pregnancy because of the anatomic and physiologic changes associated with gestation. It is also difficult to manage GI issues in pregnant women because the effects of medications and other treatments on the developing fetus are often not extensively studied or are contraindicated. While these issues are rarely life-threatening, they can cause significant distress and impair the quality of life of the pregnant woman.

Vitamin D and its significance have been well documented, especially for its impact on bone health. What may be less known is its role outside of our skeletal system. Results from several observational studies have shown that optimal vitamin D status plays a vital role and impacts the extra-skeletal system. It has been associated with a lower risk of heart disease, diabetes, respiratory infections, and lung function, among others.1
Statistics show that the prevalence of vitamin D deficiency ranges from 80-90% and is prevalent across all age-groups and risk-groups alike.2 Current guidelines suggest that vitamin D is an indispensable nutrient. When endogenous synthesis is significantly impaired, the requirements may need to be fulfilled by daily vitamin D supplementation.

Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disorder characterized by deforming symmetrical polyarthritis of varying extent and severity. It is associated with synovitis of joint and tendon sheaths, articular cartilage loss, erosion of juxta-articular bone, and the presence of IgM rheumatoid factor in the blood in most patients.1 In some patients, systemic and extra-articular features may be observed during the disease and rarely before the joint disease. These include anaemia, weight loss, vasculitis, serositis, interstitial inflammation in lungs and exocrine, salivary, and lacrimal glands, as well as nodules in subcutaneous, pulmonary, and scleral tissues.2

Osteoarthritis (OA) and Inflammatory Arthritis (IA) are two common chronic, degenerative disorders. They have a huge impact on daily self-care and the quality of life of the patients. In both OA and IA, pain is the most prominent symptom. Pain is a multifactorial process that may cause tissue damage, disability, and psychological concerns. The major aim of pain management includes improved functions, increased well-being, and reduced individual and societal costs. Inflammatory arthritis affects over 180 million people in India, more than many well-known diseases like diabetes, AIDS, and cancer. Osteoarthritis affects 15 million adults annually, with the prevalence ranging between 22 to 39% in India. This condition is more common in women than in men, and the prevalence increases with age.1 

Iron Deficiency Anaemia (IDA) is the most common type of anaemia. The condition occurs when a person’s body does not have or produce adequate amounts of mineral iron in the body.1 IDA is the most common cause of anaemia worldwide. According to the World Health Organization (WHO), out of the two billion people suffering from anaemia worldwide, approximately half of the anaemia cases are due to iron deficiency (27%).2 Current data suggest that IDA is most common among pregnant women, children, and people from low-income and middle-income countries. The condition leads to impaired cognitive and motor development among children and decreased work capacity among adults. In pregnant women, iron deficiency anaemia can lead to perinatal loss, premature or low birth weight babies.3

Respiratory conditions are on the rise worldwide, and especially in developing countries like India which accounts for an estimated 18% of the world population. Findings from the Global Burden Disease Survey 1990-2016 make it clear that both acute and chronic respiratory diseases are highly prevalent in the country. Air pollution, tobacco, biomass fuels, and occupational exposures continue to overburden the Indian healthcare system with a variety of respiratory ailments, of which ‘cough’ remains the most common initial presenting symptom.1,2

Qualitative and Quantitative Cough Assessments Are Crucial To Optimize Disease Outcomes

Chronic obstructive pulmonary disease or COPD is a common, preventable, and treatable condition characterized by persistent respiratory symptoms and airflow limitation due to structural abnormalities in the airways and alveoli. The prevalence of COPD has been consistently rising over the past several years, with an estimated 44% increase in the global burden of COPD in the past decade.
The prevalence of COPD in India has increased from 3.3% (28.1 million cases) in 1990 to 4.4% (55.3 million cases) in 2016. It is also the second most common cause of non-communicable disease-related mortality in India.1,2

Asthma is a chronic disease with prominent heterogeneity in the pattern of underlying disease mechanisms, disease severity, clinical features, and responsiveness to specific treatments. Diagnosis of asthma is predominantly made with clinical history and examination. While the majority of asthmatic patients are controlled by standard pharmacological protocols of bronchodilators, a significant subgroup has very limited therapeutic options, representing a major unmet need. This limitation can be a probable result of underdiagnosis, misdiagnosis, or overdiagnosis of asthma.1

"Modern medical advances have helped millions of people live longer, healthier lives. We owe these improvements to decades of investment in medical research."

“Research” is defined as “a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to knowledge.”

Medicine is an art whose magic and creative ability have long been recognized as residing in the interpersonal aspects of the patient-physician relationship.

A doctor’s communication and interpersonal skills comprise their ability to gather information to aid in accurate diagnosis, appropriate counseling, giving therapeutic instructions, and establishing a caring relationship with patients. These are the prime clinical skills in the practice of medicine, with the goal of achieving the best results and patient satisfaction, which is essential for the effective delivery of healthcare.1

Health is Wealth, True that! But both are equally important for a satisfactory life. Wouldn’t you agree, Doctor? Here are 4 facts as a food for thought that can change the way you think about and plan your finances.

You have worked so hard to acquire the knowledge and then put it into practice. Over a period, this knowledge and practice will surely transform into invaluable experience which will thereby help save a million lives.

Prevention is better for those who cure: Demystifying medico-legal issues in clinical practice for Doctors

You have chosen one of the noblest professions in the world and provide a service to humanity with your skills and care which makes you no less than God for most of us.

Having said that, there have been many instances in recent years which throw light on the dark side of being in this profession.

It is rightly said that "Patients cannot measure the quality of clinical care, but they can measure the quality of experience!". Irrespective of the kind of medical practice you work in, improving patient experience in healthcare is critical1

Now let us try and understand the meaning of patient experience. Patient experience encompasses the range of interactions that patients have with the healthcare system, including their care from health plans and doctors, nurses, and staff in hospitals, physician practices, and other healthcare facilities.