A study on prescribing pattern and drug utilization among depressed patients in a tertiary care teaching hospital

Background: Drug utilization is defined as the marketting, distribution, prescribing and use of drugs in society. Various factors like quality, quantity, and cost of drugs plays an important role in selection of drug therapy. Hence we wanted to observe that drug utilization and prescribing pattern of antidepressants.Methods: A prospective observational study were conducted in a psychiatric department at RMMCH for a period of 6 months from November 2019 to April 2020. Sixty patients were enrolled and analysed to study the pattern and the world health organisation (WHO) prescribing indicators.Results: From 60 prescriptions, the most widely prescribed antidepressant drug escitalopram 21 (42%) as a combination drug citalinforte 30 (50%), linotril 21 (42%) lorazepam 12 (20%), haloperidol 6 (10%) and quitipin 3 (5%). Most commonly, depression was seen in age group between 31-40 years and males were more to depression than females. Most drugs were prescribed under brand names (55%) than generic drugs (45%). Monotherapy was the preferred drug pattern for the mild depression followed by dual therapy and triple therapy for moderate and severe depression respectively. The number of drugs which were prescribed from the WHO and national list of essential medicine (NLEM) was haloperidol (10%) and escitalopram (85%) respectively.Conclusions: Escitalopram was the commonly prescribed drug for depression followed by lorazepam, linotril and haloperidol. Monotherapy was most preferred, because of increased medication adherence, low ADRs, minimum cost and lesser drug interactions compared to other therapies

Unhealthy Gambling Amongst New Zealand Secondary School Students: An Exploration of Risk and Protective Factors

This study sought to determine the prevalence of gambling and unhealthy gambling behaviour and describe risk and protective factors associated with these behaviours amongst a nationally representative sample of New Zealand secondary school students (n = 8,500). Factor analysis and item response theory were used to develop a model to provide a measure of ‘unhealthy gambling’. Logistic regressions and multiple logistic regression models were used to investigate associations between unhealthy gambling behaviour and selected outcomes. Approximately one-quarter (24.2 %) of students had gambled in the last year, and 4.8 % had two or more indicators of unhealthy gambling. Multivariate analyses found that unhealthy gambling was associated with four main factors: more accepting attitudes towards gambling (pp = 0.0061); being worried about and/or trying to cut down on gambling (p p = 0.0009). Unhealthy gambling is a significant health issue for young people in New Zealand. Ethnic and social inequalities were apparent and these disparities need to be addressed

Descriptive epidemiology of somatising tendency: findings from the CUPID study.

Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait

Relevance of laboratory testing for the diagnosis of primary immunodeficiencies: a review of case-based examples of selected immunodeficiencies

The field of primary immunodeficiencies (PIDs) is one of several in the area of clinical immunology that has not been static, but rather has shown exponential growth due to enhanced physician, scientist and patient education and awareness, leading to identification of new diseases, new molecular diagnoses of existing clinical phenotypes, broadening of the spectrum of clinical and phenotypic presentations associated with a single or related gene defects, increased bioinformatics resources, and utilization of advanced diagnostic technology and methodology for disease diagnosis and management resulting in improved outcomes and survival. There are currently over 200 PIDs with at least 170 associated genetic defects identified, with several of these being reported in recent years. The enormous clinical and immunological heterogeneity in the PIDs makes diagnosis challenging, but there is no doubt that early and accurate diagnosis facilitates prompt intervention leading to decreased morbidity and mortality. Diagnosis of PIDs often requires correlation of data obtained from clinical and radiological findings with laboratory immunological analyses and genetic testing. The field of laboratory diagnostic immunology is also rapidly burgeoning, both in terms of novel technologies and applications, and knowledge of human immunology. Over the years, the classification of PIDs has been primarily based on the immunological defect(s) ("immunophenotype") with the relatively recent addition of genotype, though there are clinical classifications as well. There can be substantial overlap in terms of the broad immunophenotype and clinical features between PIDs, and therefore, it is relevant to refine, at a cellular and molecular level, unique immunological defects that allow for a specific and accurate diagnosis. The diagnostic testing armamentarium for PID includes flow cytometry - phenotyping and functional, cellular and molecular assays, protein analysis, and mutation identification by gene sequencing. The complexity and diversity of the laboratory diagnosis of PIDs necessitates many of the above-mentioned tests being performed in highly specialized reference laboratories. Despite these restrictions, there remains an urgent need for improved standardization and optimization of phenotypic and functional flow cytometry and protein-specific assays. A key component in the interpretation of immunological assays is the comparison of patient data to that obtained in a statistically-robust manner from age and gender-matched healthy donors. This review highlights a few of the laboratory assays available for the diagnostic work-up of broad categories of PIDs, based on immunophenotyping, followed by examples of disease-specific testing

An exceedingly mild and efficient CAN mediated method for the deprotection of acetals

1234-1236<span style="font-size:12.0pt;font-family: " times="" new="" roman";mso-fareast-font-family:"times="" roman";mso-ansi-language:="" en-in;mso-fareast-language:en-in;mso-bidi-language:ar-sa"="" lang="EN-IN">An efficient and mild procedure for the deprotection of acetals using CAN(Cerium(IV) Ammonium Nitrate) has been described.</span

Synthesis, characterization of Ag doped CdS-WO2 nanocomposite and effects of photocatalytic degradation in RhB under visible light irradiation

In this paper, the highly stable Ag/CdS-WO2 nanocomposite was fabricated by a facile and capping agent-free hydrothermal technique. The fabricated Ag-doped CdS-WO2 nanocomposite was characterized by powder X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy, and UV-vis diffuse reflectance (DRS) spectroscopy. The photocatalytic performance of synthesized photocatalysts was evaluated for the photodegradation of rhodamine B (RhB) under visible light irradiation (VLI). The parameters used for the optimization of the photocatalyst were pH, catalyst dose, oxidant dose, and irradiation time. Based on this, a possible reaction mechanism for the enhancement of the photocatalytic activity of Ag/CdS-WO2 has been proposed. Hence, we have a tendency to believe it might be a promising material that may be used for the photodegradation of organic pollutants present in wastewater

Bayesian Model Selection maps for group studies using M/EEG data

Predictive coding postulates that we make (top-down) predictions about the world and that we continuously compare incoming (bottom-up) sensory information with these predictions, in order to update our models and perception so as to better reflect reality. That is, our so-called "Bayesian brains" continuously create and update generative models of the world, inferring (hidden) causes from (sensory) consequences. Neuroimaging datasets enable the detailed investigation of such modeling and updating processes, and these datasets can themselves be analyzed with Bayesian approaches. These offer methodological advantages over classical statistics. Specifically, any number of models can be compared, the models need not be nested, and the "null model" can be accepted (rather than only failing to be rejected as in frequentist inference). This methodological paper explains how to construct posterior probability maps (PPMs) for Bayesian Model Selection (BMS) at the group level using electroencephalography (EEG) or magnetoencephalography (MEG) data. The method has only recently been used for EEG data, after originally being developed and applied in the context of functional magnetic resonance imaging (fMRI) analysis. Here, we describe how this method can be adapted for EEG using the Statistical Parametric Mapping (SPM) software package for MATLAB. The method enables the comparison of an arbitrary number of hypotheses (or explanations for observed responses), at each and every voxel in the brain (source level) and/or in the scalp-time volume (scalp level), both within participants and at the group level. The method is illustrated here using mismatch negativity (MMN) data from a group of participants performing an audio-spatial oddball attention task. All data and code are provided in keeping with the Open Science movement. In doing so, we hope to enable others in the field of M/EEG to implement our methods so as to address their own questions of interest

CASE REPOCASE REPORT ON METHOTREXATE-INDUCED ANGIOEDEMA, PANCYTOPENIA, AND STEVENS-JOHNSON SYNDROMERT ON METHOTREXATE INDUCED ANGIOEDEMA, PANCYTOPENIA AND STEVENS - JOHNSON SYNDROME

ABSTRACTA 52-year-old female patient was presented with the complaints of swelling of lips, difficulty in breathing, difficulty in swallowing of food, itching,and facial puffiness and also showed the history of a skin lesion in the neck, forearm, and genitalia. Medical history of the patient showed that shehad been prescribed with methotrexate for rheumatoid arthritis. Within 10 days of treatment, the patient developed above mentioned signs andsymptoms. Further upon patient's systemic and physical examinations were done and then a diagnosis of pancytopenia, angioedema, and StevensJohnsonsyndromeweremade. AccordingtoNaranjoadversedrugreactioncausality assessmentscale,the association ofangioedema,pancytopenia,andStevens-Johnsonsyndromedue tomethotrexatewasprobable.Methotrexatewaswithdrawnfromthe patient,and the patient wastreatedwithmethotrexateantagonist Leucovorinfor3dayswith afrequencyof thrice dailyand injection Avil(Pheniraminemaleate)with afrequencyof twicedailywhichresolvedthe complications of the patient.Keywords: Methotrexate, Angioedema, Pancytopenia, Stevens-Johnson syndrome

A mild and efficient procedure for the preparation of dimethyl and diallyl acetals of aromatic aldehydes mediated by cerium(lV) ammonium nitrate

141-143The reaction of aromatic aldehydes with cerium(IV) ammonium nitrate (CAN) in alcohols to afford the corresponding acetals is described