A retrospective study of drug utilization pattern in the outpatient department of pediatrics in a tertiary care teaching hospital of Rajasthan, India

Background: Though irrational prescribing is known throughout the world, but in developing countries because of small amount of funds available in the overall health budget for drugs, it has become more meaningful to prescribe drug rationally for optimum use of the allocated funds. The objective of this study was to study drug utilization pattern in paediatric patients attending paediatrics outpatient department, J. L. N. Hospital, Ajmer, Rajasthan. Methods: Study was carried out retrospectively, for a period of one year, by analysing a total 2100 carbon copies of prescriptions of patients who had visited the O.P.D. of Pediatric of J. L. N. Hospital Ajmer.Results: Among the total of 2100 patients, 67.71% patients were in age group of 1 to 14 years. 56.76% of total prescriptions accounted for the respiratory system followed by gastrointestinal system (26.62%). The most frequent classes of drugs prescribed were: antimicrobials (77.42%) followed by analgesic-antipyretics (69.28%). Cephalosporins were the most common among the antimicrobials prescribed. Total 7531 drugs were prescribed. The average number of drugs per prescription was 3.59.  Of total medicine formulations prescribed, only 13.09% were prescribed by generic names and 38.03% were matching with those listed in model list of essential medicines. 50.68% medicine formulations were in the form of fixed dose combinations (FDCs) of which 26.96% were form the essential medicine list.Conclusions: There is a lot of scope in prescribing pattern regarding poly-pharmacy, medicines prescribed by generic name and from Essential Drug List and usage of fixed dose combinations

A case report of pulmonary and muscular cysticercosis

Pulmonary cysticercosis is extremely rare manifestation of a rather common disease which is distributed worldwide. Most common sites for the growth of cysticercosis are muscle and brain followed by eye. Pulmonary involvement in cysticercosis is very rare and if at all present, then ill-defined nodular shadows distributed throughout the lung is the usual radiological presentation which might be attributed to other diseases also. No case of cysticercosis presenting as lung parenchymal along with muscular involvement without cerebral involvement has been reported so far in literature. We came across a rarest presentation of cysticercosis as pulmonary involvement. After nullifying all the differential diagnosis of parenchymal nodular lesions as seen on CT chest and with clinical suspicion, a diagnosis of pulmonary cysticercosis was made as enzyme linked immunosorbent assay (ELISA) titres for cysticercosis was significantly raised. Case was successfully treated with albendazole (15 mg/kg) with steroid cover with resolution of lesions as well.

Design Simulation and Assessment of Cellular Automata Based Improved Image Segmentation System

A variety of methods may be found in the numerous image segmentation techniques. Here a method of text retrieval conducted is typically to produce a collection of localized features. In computer science, object recognition is the problem of automatically "identifying", or classifying, an object. In certain instances, the awareness of artifacts is deeper into image in image segmentation through image processing. The algorithm used for image segmentation has a direct impact on the outcome of the whole approach, therefore it is important to choose carefully. It is important to choose a segmentation method appropriate for a certain framework. There are several ready-to-use segmentation methods, so one by one evaluate the tools to see which works best. Segmentation algorithms have reached such a level of complexity that a research employing them is often considered impractical. The given research undertakes the process of improved graph cut method to select the foreground and background of image through labelling and segmentation of the image. Results have been compared on the performance parameter to analyse the effectiveness of the proposed algorithm for segmentation of the images

Adverse events of albendazole due to mass drug administration

Background: Soil-transmitted helminths are mostly prevalent in developing countries due to poor sanitation and lack of adequate clean water. The present study examines adverse events (AEs) experienced following administration of albendazole to children (2-19 Years) at Uttarakhand on national de-worming day.Methods: Children were given single doses of albendazole on national de-worming day. Some of children experienced adverse events and were admitted in hospital of Govt Medical college Haldwani (Uttarakhand). Data were collected and analyzed.Results: Total twenty five children were admitted due to albendazole adverse events. Out of these 92% were female. Mean age of admitted children was 14.14 years with standard deviation 3.45. Mean onset of adverse events was 5.6 hours with standard deviation of 1.5 hours. All children were treated symptomatically and were discharged once they recovered. No fatality due to adverse events was observed. Average duration of stay in hospital was 3.4 days. Out of twenty five children 12% children reported four or more adverse events, 40% children reported three adverse events and 48% reported two adverse events. Out AEs, 33% AEs were mild, 19% AEs were moderate, 31% AEs were severe and 17% AEs were serious. Abdominal pain was reported by 76%, headache by 44%, loss of consciousness by 32%, vomiting by 28%, nausea by 16%, convulsions by 12%, rashes by 8%, fever by 8%, and breathlessness by 14% and vertigo by 4%.Conclusions: The adverse events were mild to serious but transient, but all of them recovered after hospitalization. Therefore, it is imperative that mass drug administration programmes put in place surveillance measures in order to ensure timely detection, management and reporting of potential life threatening AEs

Operation Control and Analysis of a Hybrid AC/DC Microgrid

Distributed renewable energy production is making smart microgrid concepts based on AC, DC, and hybrid-MG design more attractive (DRE). In light of the growing population and the pressing need to minimize the load, research into effective control techniques and architectural solutions is a hot topic right now. However, a comprehensive and coordinated literature assessment of hierarchical control approaches based on diverse configurations of the microgrid (MG) architecture has been explored relatively little in the past.\u27\u27 Primary, secondary, and tertiary methods to MG system control are outlined in this suggested method. Primary, secondary and third-tier techniques are examined for each MG structure in a short literature review. In addition, the paper offers the best and worst aspects of current control methods. In addition, a simulation research connected to the literature review\u27s future trends in MG control is offered as a further contribution to this subject. Since renewable energy supplies are intermittent in nature, a hybrid microgrid is needed to minimize overall deficit inadequacies and increase system dependability. This is due to the depletion of natural resources and to the intermittent nature of renewable energy resources. Using a hybrid microgrid, the present distributed and concentrated load situations may be accommodated. In order to better understand how the hybrid microgrid may be integrated, optimized and controlled, there is a growing demand for research. It is necessary to do a thorough evaluation of the performance, efficiency, dependability, security, design flexibility, and cost-effectiveness of a hybrid microgrid. Issues such as AC and DC microgrids integrating into a single hybrid microgrid are discussed in this paper, as well as how to manage renewable energy resources in a cost-effective manner and how to place the optimal number of feeders in a microgrid. There is a quick overview of the primary research fields, with the goal of finding the research gap that may further enhance the grid\u27s performance. \u27\u27New hybrid microgrid solutions are being offered in light of current study trends that have been determined to be the most effective and most-friendly. Research, comparative analysis, and further development of new methodologies related to hybrid microgrids will be aided by this study as the foundation for future wor

Prescribing pattern of drugs in sick newborn care unit in a tertiary care hospital, Haldwani, Uttarakhand, India

Background: Sick Newborn Care Unit (SNCU) is meant to reduce the case fatality among sick newborns. Although it has been shown that patterns of drug utilization in SNCU are changing dynamically, current data on drug utilization patterns in SNCU is limited. This study was done to find out drug utilization pattern in newborn admitted at SNCU.Methods: This prospective observational drug utilization study was carried out in SNCU of Government Medical College and Hospital, Haldwani (Uttrakhand). The pattern of drug use in 206 sick newborn admitted at SNCU was assessed.Results: 75.25% sick newborns were in early neonatal period and 63.11% sick newborns were male. 33.98% sick newborn were preterm and mean±SD of weight of sick newborn was 2.16±0.6kg. Neonatal sepsis was commonest reason for admission followed by birth asphyxia . Three or more drugs (average 2.35drug/ Range 3-9 drug) were given to 52.91% new born and two drugs were given to 40.78% new born. Commonest route of drug administration was intravenous (97.08%), followed by intramuscular (72.82%), followed by orally (13.59%) and 11.65% new born received drug by inhalation. Most frequently used drugs in SNCU were antibiotics (Ampicillin, Gentamicin, Amikacin, Cefotaxime). Only two adverse drug reactions (mild rash by ampicillin and fever) were reported during study period. Out of 206 sick newborn, 18.93% died. Most common causes for death were respiratory distress syndrome (41.03%) followed by sepsis (23.08%) and hypoxic ischemic encephalopathy (17.95%).Conclusions: Antibiotics were of major concern in SNCU. The uncertainty regarding the choice of antibiotic can be minimized by periodic survey of etiological agent and their antibiotic susceptibility pattern

WISE Causal Models: Wisdom Infused Semantics Enhanced Causal Models - A Study in Suicidality Diagnosis

The COVID-19 Pandemic has highlighted the gap between the number of mental health care seekers and care providers. Netizens have taken to internet-based platforms such as Reddit to express their experiences. Mental illness diagnosis processes have clinically accepted causal interpretations and semantics. Curiously, mental illness diagnosis accuracy is low relative to similar well-studied illnesses. Motivated by this discrepancy, we propose Wisdom Infused Semantics Enhanced (WISE) causal models, inspired by the wisdom of the crowd idea that learns from a collective agreement among causal models and their semantics for mental illness diagnoses. We use suicidality diagnosis task descriptions, datasets, and baseline methods to evaluate the effectiveness of WISE causal models. Our experiments show that learning WISE causal models improve performance on these tasks

Distribution, Composition Profiles and Source Identification of Polycyclic Aromatic Hydrocarbons in Roadside Soil of Delhi, India

Distribution, composition profiles and sources of polycyclic aromatic hydrocarbons (PAHs) were evaluated in roadside soils from Delhi, India. PAH determination was made by Sonication extraction and chromatographic clean-up with final analysis by high performance liquid chromatography with ultraviolet-diode array detector (HPLC-UV-DAD).The average concentration of ∑PAHs was 6838.6±3528.4 µg kg-1 and ranged between 81.6 to 45017.4 µg kg-1. Seven possible carcinogenic PAHs (7c-PAHs) accounted 67.4% to the total PAHs. Diagnostic ratios of individual PAHs and LMWPAHs to HMWPAHs ratio were calculated and applied to assess the possible sources of PAHs which, indicates the mixed pyrogenic activities such as petroleum, biomass and coal combustion are the main contributors. Although, concentrations of individual PAHs were lower than the guideline values but, the concentrations of some high molecular weight PAHs were higher at the locations in the vicinity of industrial areas and there is probable some risk to human health. Keywords: Polycyclic aromatic hydrocarbons (PAHs), HPLC-UV, roadside soil, diagnostic ratio, Indi

Residues of Pesticides and Herbicides in Soils from Agriculture Areas of Delhi Region, India

This paper presents the residue levels of organochlorine, organophosphate pesticides and herbicides in agricultural soils from Delhi region. Among OCPs, HCH, DDT endosulphan and dieldrin ranged between <0.01-104.14 ng g-1, <0.01-15.79 ng g-1, <0.01-7.57 ng g-1 and <0.01-2.38 ng g-1, respectively. The concentration of OPPs ranged from <0.01-20.95 ng g-1, ND-3.92 ng g-1, ND-31.73 ng g-1, ND-6.46 ng g-1 and ND-6.46 ng g-1 for phosphomidon, monocrotophos, chlorpyriphos, quinolphos and ethion, respectively. Pendimethalin (0.27 ng g-1) was the dominant herbicides followed by butachlor (0.19 ng g-1), and fluchloralin (0.05 ng g-1). Data showed the region was contaminated by technical DDT and technical HCH mixture. The study reveals that the level of some organochlorine pesticides in agricultural soils is a matter of concern for future food chain accumulation and human health so; regular investigation of pesticide residues is recommended on soil health and contamination levels. Keywords: pesticides, herbicides, agricultural soil, Delhi, Indi

Employee perception of impact of knowledge management processes on public sector performance

Purpose The application of knowledge management (KM) is critical to public sector firm as it is to private sector firm. However, despite its significance, the academic enquiry of KM in public sector is at its nascent stage. This forms the motivation of the present work; this paper aims to analyze and understand the intricate relationship between KM processes and public sector firm performance in terms of operational, quality and innovation performance. Design/methodology/approach A comprehensive KM processes–performance framework consisting of seven constructs (four constructs of KM processes and three constructs of KM performance) and their underlying factors was developed through an extensive literature review. The employee perceptions of these seven constructs were captured on a five-point Likert scale using a country-wide survey in the UAE public sector. The 270 valid responses captured were then used to first validate the KM framework and then test the hypothesized relationships between KM processes and KM performance. Findings The findings show that all four KM processes (knowledge creation, knowledge capture and storage, knowledge sharing and knowledge application and use) had a positive and significant impact on operational, quality and innovation performance of public sector in the UAE. Research limitations/implications The findings confirm the validity and reliability of all the seven constructs and their underlying factors and the assessment framework. Overall, this study fills a gap in the literature about applying/implementing a KM framework for the public sector and therefore significantly contributes toward the theoretical advancement of the field. However, the study does acknowledge the use of perceptual measures of individual employees as a limitation instead of more objective measures to capture the impact KM processes on KM performance. Practical implications The strong and significant impact of KM processes on firm performance is expected to provide the impetus for practitioners and policymakers to implement and leverage from KM processes and improve firm performance in the public sector. Originality/value A comprehensive development, validation and assessment of a KM framework for the public sector has not been attempted previously anywhere, let alone UAE, and hence constitutes the novelty of this work