PATTERNS OF PRESCRIPTION AND ADR MONITORING OF DRUGS IN THE MANAGEMENT OF NEUROPATHIC PAIN IN A TERTIARY CARE TEACHING HOSPITAL

Objective: Neuropathic pain arises from demage, or the pathological changes in the peripheral or central nervous sytem. The pain is difficult to treat as standard treatment with conventional analgesics doesn`t typically provide effective relief of pain. Methods: It was a one year study of utilization and analysis of prescriptions for PNDs (Painful neuropathic disorders). The parameters evaluated were demographic profile of the patient (age and gender), type and etiology of PNDs, drug data (name of the group of drugs with individual drugs, mono or polytherapy, number of drugs per prescription, formulation) and associated adverse drug reactions(ADR) with the prescribed drug. Results: Maximum number of patients of PNDs resides in the age group of 18 – 35 yrs (41.2%) & more common in females. The most common PND encountered was painful diabetic neuropathy (43.9%) followed by cervical and lumbar radiculopathy, post herpetic neuralgia. 2942 drugs were prescribed in 1020 prescriptions out of which, 96.8% were oral and 3.2% were topical formulations. Most frequently prescribed group of drug was tricyclic antidepressant (27.3%) followed by anticonvulsants (25.3%). Polypharmacy was seen 89.7% as compared to monotherapy (10.3%). Only 132 ADRs of various types were seen. The most common organ system affected was central nervous system followed by gastro intestinal systems. The most common drugs implicated for ADRs were TCAs (24.4%), anticonvulsants (16.6%), and Pregabeline (9.8%). There were no fatal adverse events. Mild to moderate ADRs included constipation, nausea, vomiting, drowsiness, dryness of mouth. Conclusions: The choice of drug depends on etiology of neuropathic pain, drug efficacy and availability and also on ADR profile

PATTERNS OF PRESCRIPTION AND ADR MONITORING OF DRUGS IN THE MANAGEMENT OF NEUROPATHIC PAIN IN A TERTIARY CARE TEACHING HOSPITAL

Objective: Neuropathic pain arises from damage or pathological changes in the peripheral or central nervous system. The pain is difficult to treat as standard treatment with conventional analgesics doesn`t typically provide effective relief of pain. Methods: It was a one-year study of utilization and analysis of prescriptions for PNDs (Painful neuropathic disorders). The parameters evaluated were demographic profile of the patient (age and gender), type and etiology of PNDs, drug data (name of the group of drugs with individual drugs, mono or polytherapy, number of drugs per prescription, formulation) and associated adverse drug reactions (ADR) with the prescribed drug. Results: Maximum number of patients of PNDs resides in the age group of 18 – 35 yrs (41.2%) and more common in females. The most common PND encountered was painful diabetic neuropathy (43.9%) followed by cervical and lumbar radiculopathy, postherpetic neuralgia. 2942 drugs were prescribed in 1020 prescriptions out of which 96.8% were oral and 3.2% were topical formulations. Most frequently prescribed group of the drug was tricyclic antidepressants (27.3%) followed by anticonvulsants (25.3%). Polypharmacy was seen 89.7% as compared to monotherapy (10.3%). Only 132 ADRs of various types were seen. The most common organ system affected was the central nervous system followed by gastro intestinal systems. The most common drugs implicated for ADRs were TCAs (24.4%), anticonvulsants (16.6%), and Pregabeline (9.8%). There were no fatal adverse events. Mild to moderate ADRs included constipation, nausea, vomiting, drowsiness, dryness of mouth. Conclusions: The choice of drug depends on etiology of neuropathic pain, drug efficacy and availability and also on ADR profile

Odonates of three selected tiger reserves of Madhya Pradesh, Central India

Odonates (Damselflies and Dragonflies) were recorded from three Tiger Reserves of Madhya Pradesh, Central India, including Kanha, Pench and Bandhavgarh, where 47 species were recorded within 7 families and 31 genera. We recorded 44 species from Kanha, 41 species from Pench and 37 species from Bandhabgarh Tiger Reserve. Thirty-five species were recorded in all three tiger reserves. Suborder Zygoptera was represented by the families Coenagrionidae, Lestidae, Calopterygidae and Protoneuridae and suborder Anisoptera by the families Gomphidae, Libellulidae and Aeshnidae. Libellulidae was the largest family with 17 genera. In summer survey Orthetrum sabina Drury, 1770 was the most abundant species, while in winter the most abundant was Agriocnemis pygmea Rambur, 1842

Sociodemographic profile and pattern of superficial dermatophytic infections among pediatric population in a tertiary care teaching hospital in Odisha

Background: There is a recent rising trend of superficial dermatophytic fungal infections all over the globe. Apart from the causative organisms, there are many modifiable environmental factors contributing to this sudden pandemic. The prevalence of the disease in the pediatric age group needs to be studied more vigorously. Materials and Methods: All children in the age group of 2–15 years with dermatophytic infections were studied for the pattern of infection and various environmental associations. Results: Most (102 [51.51%]) of the patients belonged to 11–15 years age group with tinea cruris (99 [50%]) and tinea corporis (94 [47.47%]) type of pattern being the most common. The majority (175 [88.38%]) of the patients belonged to rural and semi-urban locality with improper sanitation system and poor quality of water source in use by the patients. Conclusion: This study highlights the prevalent pattern of dermatophytic infections in children in our locality

Progressive symmetric erythrokeratoderma: A rare case report

Erythrokeratodermas are a rare group of genetic disorders presenting early in childhood as erythematous, hyperkeratotic plaques on the skin. There may be associated neurological involvement. A 12-year-old boy presented with symmetric keratotic plaques on the body since infancy. Psoriasis and pityriasis rubra pilaris were ruled out after histopathological examination of the skin. We are reporting a case of progressive symmetric erythrokeratoderma with classical lesions but can be missed due to unawareness

Acute methotrexate toxicity due to overdosing in psoriasis: A series of seven cases

Overdosing is the major cause of acute methotrexate toxicity in psoriasis patients. There are no published data regarding the acute cumulative dose causing acute toxicity, duration to achieve acute cumulative toxic dose and various reasons for wrong dosing of methotrexate in Indian patients. We are presenting a series of seven cases of toxicity due to overdosing of methotrexate in psoriasis. The acute cumulative dose of methotrexate ranging from 35 mg to 150 mg, taken over 3–7 days was responsible for acute toxicity in the psoriasis cases. Lack of counselling regarding the disease course, drug dosing, schedule and awareness about possible outcome of high and daily dose were found to be the causes of overdosing and toxicity in our patients. All cases presented with ulceration, bleeding and pain in skin lesions and five cases had oral mucosal ulceration and genital mucosa was involved in two cases. All cases were given injectable folinic acid. Five cases recovered and two cases expired. Authors postulate counselling about the course of disease, regarding dosing schedule of methotrexate and consequences of methotrexate overdosing is mandatory for all patients of psoriasis in country like India where drug regulation is not strict to prevent methotrexate toxicity and its dreaded consequences

Data quality monitors of vertex detectors at the start of the Belle II experiment

The Belle II experiment features a substantial upgrade of the Belle detector and will operate at the SuperKEKB energy-asymmetric e+e− collider at KEK in Tsukuba, Japan. The accelerator completed its first phase of commissioning in 2016, and the Belle II detector saw its first electron-positron collisions in April 2018. Belle II features a newly designed silicon vertex detector based on double-sided strip layers and DEPFET pixel layers. A subset of the vertex detector was operated in 2018 to determine background conditions (Phase 2 operation). The collaboration completed full detector installation in January 2019, and the experiment started full data taking. This paper will report on the final arrangement of the silicon vertex detector part of Belle II with a focus on online monitoring of detector conditions and data quality, on the design and use of diagnostic and reference plots, and on integration with the software framework of Belle II. Data quality monitoring plots will be discussed with a focus on simulation and acquired cosmic and collision data

Measurement of the branching fractions for Cabibbo-suppressed decays D+→K+K−π+π0D^{+}\to K^{+} K^{-}\pi^{+}\pi^{0} and D(s)+→K+π−π+π0D_{(s)}^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0} at Belle

International audienceWe present measurements of the branching fractions for the singly Cabibbo-suppressed decays $D^+\to K^{+}K^{-}\pi^{+}\pi^{0}$ and $D_s^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0}$, and the doubly Cabibbo-suppressed decay $D^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0}$, based on 980 ${\rm fb}^{-1}$ of data recorded by the Belle experiment at the KEKB $e^{+}e^{-}$ collider. We measure these modes relative to the Cabibbo-favored modes $D^{+}\to K^{-}\pi^{+}\pi^{+}\pi^{0}$ and $D_s^{+}\to K^{+}K^{-}\pi^{+}\pi^{0}$. Our results for the ratios of branching fractions are $B(D^{+}\to K^{+}K^{-}\pi^{+}\pi^{0})/B(D^{+}\to K^{-}\pi^{+}\pi^{+}\pi^{0}) = (11.32 \pm 0.13 \pm 0.26)\%$, $B(D^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0})/B(D^{+}\to K^{-}\pi^{+}\pi^{+}\pi^{0}) = (1.68 \pm 0.11\pm 0.03)\%$, and $B(D_s^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0})/B(D_s^{+}\to K^{+}K^{-}\pi^{+}\pi^{0}) = (17.13 \pm 0.62 \pm 0.51)\%$, where the uncertainties are statistical and systematic, respectively. The second value corresponds to $(5.83\pm 0.42)\times\tan^4\theta_C$, where $\theta_C$ is the Cabibbo angle; this value is larger than other measured ratios of branching fractions for a doubly Cabibbo-suppressed charm decay to a Cabibbo-favored decay. Multiplying these results by world average values for $B(D^{+}\to K^{-}\pi^{+}\pi^{+}\pi^{0})$ and $B(D_s^{+}\to K^{+}K^{-}\pi^{+}\pi^{0})$ yields $B(D^{+}\to K^{+}K^{-}\pi^{+}\pi^{0})= (7.08\pm 0.08\pm 0.16\pm 0.20)\times10^{-3}$, $B(D^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0})= (1.05\pm 0.07\pm 0.02\pm 0.03)\times10^{-3}$, and $B(D_s^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0}) = (9.44\pm 0.34\pm 0.28\pm 0.32)\times10^{-3}$, where the third uncertainty is due to the branching fraction of the normalization mode. The first two results are consistent with, but more precise than, the current world averages. The last result is the first measurement of this branching fraction