Individualised benefit-harm balance of aspirin as primary prevention measure - a good proof-of-concept, but could have been better ...

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Best technique for fixation of displaced transverse olecranon fractures: tension band wiring or plate fixation?

Background: Fractures of olecranon are common fractures in upper limb. Tension band wiring (TBW) and plate fixation (PF) are mostly used techniques but choice is based on type of fracture and surgeon’s preference.Methods:  A study assessed functional results in 28 patients that were enrolled after the clinical event of trauma has occurred. Patients were divided into two groups- Group (A) for TBW and Group (B) for PF; here gender, age and side of fracture were ignored. Post-operative functional outcome were evaluated by using the Mayo Elbow Performance (MEP) and the Disabilities of the Arm, Shoulder and Hand (DASH) score parameters.Results: Mean (SD) union time as determined by postoperative radiographs was 8.5 (1.48) weeks for group (A) and 9 (2.08) weeks for group (B). Mean (SD) MEP score at 9 months in group (A) 84.28 (7.28) and 80.71 (10.92) in group (B). Mean (SD) DASH at 9 months in group (A) 12.2 (8.8) and 11.7 (10.4) in group (B). Complications were reported in group (A) 6 patient (42.85%) out of 14 patients and in group (B) 1 patient (7.14%) out of 14 patients.Conclusions: The current study shows that there are no significant differences in functional outcome between both the study groups. Due to lesser complications, we recommend the plate fixation approach as the better choice for transverse displaced olecranon fractures. More large scale studies are required to further confirm our results

STUDY OF FIXED DOSE COMBINATIONS IN A TERTIARY CARE HOSPITAL

ABSTRACTObjective: To study and analyze the pattern of fixed dose combinations (FDCs) in medicine outpatient clinic.Methods: The study is prospective cross-sectional study was conducted for 2 months in medicine outpatient clinic in tertiary care hospital. Aftertaking approval from Institutional Ethics Committee, the data were collected on every working day of the hospital. Prescriptions from the patientscoming to medicine outpatient clinic outpatient department were taken and required information is filled in data record form.Results: A total of 83 prescriptions were included in the study. Out of 287 drugs, 111, i.e., 39.92% were fixed dose formulations. As per drug categoryanalysis, nutritional supplements were used (47.74%). While 27.02% and 9.03% of FDCs were given for cardiovascular complains and respiratorycomplains, respectively. FDCs used for other conditions were 16.21%. About 29.72% of total FDCs are included in approved list of FDCs by DrugsController General of India (DCGI), November 2014.Conclusion: 39.92% drugs are FDCs out of total prescribed drugs. Nutritional supplements are prescribed in higher concentrations. Out of total FDCsonly 29.72% were included in DCGI approved list of FDCs and only four FDCs are found in the WHO list of essential drugs.Keywords: Fixed dose combinations, Prescriptions, Approved, Drugs Controller General of India

Effects of angiotensin converting enzyme inhibitor: ramipril on different biochemical parameters in essential hypertensive patients

Background: Hypertension is a major risk factor for macrovascular diseases. The beneficial effects of lowering blood pressure on the vascular morbidity and mortality are well documented and demonstrated. The beneficial effects of antihypertensive agents on cardiovascular system can be counter-balanced by the induction of metabolic disorders. The modifications in various metabolic parameters (like lipids, serum electrolytes, uric acid, blood glucose levels, etc) are responsible for different adverse drug reactions of antihypertensive drugs. It might also have potential to produce secondary morbidities after long term use. The present study was designed to evaluate the effect of the commonly used first line antihypertensive drugs on these different biochemical parameters. Recent comparative studies suggest that, for the prevention of cardiovascular events, angiotensin converting enzyme inhibitor (ACEI) may be superior to alternative antihypertensive agents, independently of their antihypertensive effect and also claimed to have neutral or favourable effects on carbohydrate metabolism, lipid profile, uric acid. The metabolic abnormalities can be improved by ACEI. Therefore, this study was conducted to evaluate the effects of ramipril on different biochemical parameters in essential hypertensive patients. Objective was to study effects of six months monodrug therapy with ramipril on different biochemical parameters in essential hypertensive patients.Methods: 30 newly diagnosed patients of either gender with essential hypertension were included in the study. Patients having co-morbidities like diabetes mellitus, hyperlipidemia, gout, pregnant females were excluded from the study. Baseline readings of lipid profile, serum electrolytes, fasting blood sugar and uric acid were recorded before starting ramipril drug therapy. Same biochemical tests were repeated after six months ramipril monodrug treatment.Results: After comparing the means there is significant decrease in triglyceride levels, highly significant decrease in LDL, uric acid, sodium and fasting sugar level and highly significant increase in HDL levels.Conclusions: Ramipril has beneficial effects on RAS (Renin angiotensin system) and kinin system or both may contribute to the improvement in different biochemical parameters by ramipril

A study of prescribing pattern of drugs in patients of cardiovascular emergencies at a tertiary care hospital of Western Maharashtra

Background: The main objective of drug utilization research is to assess the rationality of drug use. Recently it has been found that cardiovascular disease is the most frequent cause of morbidity and mortality throughout the world. The objective of present study was to focus on the trends in prescribing patterns of most frequently treated cardiovascular emergencies.Methods: A retrospective descriptive study was carried out in cardiovascular emergency patients. From the medical records the following data was collected:  Distribution of cardiovascular emergencies (age and sex wise), most common cardiovascular emergencies treated, outcome of each patient, average duration of stay in the hospital and drugs prescribed per patient,  correlation of clinical outcome with treatment if possible, drug utilization trend in cardiovascular emergencies. From the data, master chart was prepared for data analysis.Results: Total 82 patients case records were studied. Myocardial infarction (50%) was the most common cardiovascular emergency treated during study period followed by unstable angina (36.58%).  Male to female ratio was 1.83. Average hospital stay was found 5.75 days. The average number of drugs per patient was 8.4.  Hypertension (42.24%) and diabetes mellitus (19.51%) were the most common comorbidities found associated with cardiovascular emergencies. Aspirin clopidogrel combination (80.49%), enoxaparin (75.61%), atorvastatin (73.17%), glyceryl trinitrate (73.17%) were the most commonly prescribed drugs. The utilization rate of ACE inhibitors and ARBs (56.10%) was found higher than that of beta blockers (28.05%). Stool softeners (52.46%) and anxiolytics (28.58%) were the most commonly used non-cardiovascular drugs. Improvement was seen in 82.93% patients.Conclusions: Protocol of management strategy of cardiovascular emergencies in our tertiary care hospital was found near to standard recommended guidelines. Keywords:

ANTIMICROBIAL UTILIZATION PATTERN OF URINARY TRACT INFECTION IN TERTIARY CARE HOSPITAL

Objective: To study and analyze the pattern of antimicrobial utilization in urinary tract infection (UTI).Methods: A descriptive retrospective study was conducted in tertiary care hospital for 6 months including both male and female patients of all agegroups. Case sheets diagnosed with UTI based on ICD-10 disease coding were collected from medical records department. The demographic dataand prescription pattern of each case sheet were evaluated in detail. Drug utilization pattern was compared among different age groups of patients.Results: A total of 108 patients were included in the study, out of which 44.4% were males, and 55.6% were females. Most of the patients were in40-60 years age group (40.7%). UTI confirmed by culture in 59.26% patients; in which Escherichia coli was isolated in 35.9% patients followedby Klebsiella species (14.06%) and Pseudomonas aeruginosa (7.8%). Cephalosporins (70.37%) were most commonly used antibiotic followed byfluoroquinolones (38.89%), penicillins (29.63%), azithromycin (17.59%), and aminoglycosides (15.74%). Among the cephalosporins, third generationparenteral was most commonly used. In penicillins, amoxicillin + clavulanic acid combination was used in 9 patients. Amikacin was most commonlyused aminoglycoside followed by gentamicin. Mean duration of treatment was 6.28±3.02 days.Conclusion: Third generation cephalosporins (ceftriaxone and cefixime) were used as first line drug in most of the cases irrespective of the causativeorganism. This group should be reserved for complicated UTIs.Keywords: Urinary tract infections, Escherichia coli, Cephalosporins, Fluoroquinolones

Smart hybrid nanostructures for cancer treatment

The project leading to this work has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 751903

Performance of the Xpert HPV assay in women attending for cervical screening

© 2015 The Authors. Objectives: This study evaluated the Xpert HPV Assay in women attending screening in general practice by comparing Xpert with two established HPV tests, cytology and histology. Methods: A prospective study in women aged 20-60 years attending screening in Bristol, Edinburgh and London using residual Preservcyt cytology samples. Sample order was randomised between Roche cobas4800 and Cepheid Xpert assays with Qiagen hc2 third. Results: 3408 cases were included in the primary analysis. Positivity for Xpert was 19.6%, cobas 19.2% and hc2 19.9% with high concordance (kappa=86.8% vs cobas, 81.55 vs hc2). Xpert, cobas and hc2 showed similar sensitivity (98.7%, 97.5%, 98.7%) for CIN2+. All pairwise comparisons had high concordance (Kappa ≥0.78 with any abnormal cytology. Xpert and hc2 were positive for all cases of ≥moderate dyskaryosis ( N=63)), cobas was negative in two. Histology was available for 172 participants. 79 reported CIN2+, 47 CIN3+. All CIN3+ was positive on Xpert and hc2 and one case negative for cobas. One case of CIN2 was negative for all assays. Conclusions: The performance of Xpert HPV Assay in a general screening population is comparable to established HPV tests. It offers simplicity of testing, flexibility with non-batching of individual samples and rapid turnaround time

Effect of Smokeless Tobacco Consumption on Lipid Profile

ABSTRACT Tobacco consumption is a greater source of mortality and morbidity. About 35 to 40 % of tobacco consumption in India is in smokeless forms. Tobacco in any form increases serum cotinine level. The effect of increased serum cotinine level on lipid profile was studied in adult male rural population. Studies have shown increased prevalence of cardiovascular disease risk factors like increased in triglyceride, VLDL and decreased in HDLc in study group when compared to control group. Age matched adult male of rural population in Western Maharashtra between 22 to 56 years of age were included in the study. After estimation of serum cotinine level, study group were further divided into three sub groups according to tobacco chewing duration (years), frequency (perday) and serum cotinine level. (ng/ml) Lipid profile of the study and control group was determined and compared statistically. Out of 175 subject, 95 were tobacco chewers (study group) and 80 were tobacco non-chewers (control group). Triglyceride and VLDL were significantly higher (p<0.05) and HDLc was found significantly decreased (p<0.05, p<0.01, p<0.001) in study group with respect to increased tobacco chewing duration, frequency and serum cotinine level as compared to control group. There was significantly and progressively increase in triglyceride and VLDL and decrease in HDLc in tobacco chewers according to tobacco chewing duration, frequency and serum cotinine level as compared to control group

Research Paper A Convenient One-Pot Synthesis of 2-Amino-4-Phenyl-1,8-Naphthyridine-3-Carbonitrile Derivatives

Abstract: A simple, efficient and one-pot procedure has been described for the synthesis of 2-amino-4-phenyl-1,8-naphthyridine-3-carbonitrile derivatives. A mixture of 2-amino pyridine, malononitrile and aromatic aldehydes were reacted in presence of catalytic amount of 3-nitrophenylboronic acid as catalyst at room temperature to produce 2-amino-4-phenyl-1,8-naphthyridine-3-carbonitriles. The mild reaction condition, short reaction time, high yield and simple experimental operation are the salient future of this method