Open and Closed Reduction for Developmental Dysplasia of the Hip in New York State: Incidence of Hip Reduction and Rates of Subsequent Surgery.

BackgroundThere are limited data on the incidence and outcomes of open and closed hip reduction in patients with developmental dysplasia of the hip (DDH). The aims of this study were to determine the incidence of open and closed reduction of the hip using population-level data and to assess the rates of subsequent surgery.MethodsChildren aged 3 years and younger with DDH who underwent open or closed reduction of the hip between 1997 and 2013 were identified in the New York Statewide Planning and Research Cooperative System (SPARCS) database. Patient age, sex, race, and insurance status as well as concurrent procedures were extracted. Admissions through 2014 were searched for subsequent surgeries, providing a minimum 1-year post-reduction surveillance for all patients. Age-specific incidence rates were calculated using New York State annual population data. The rates of concurrent and subsequent surgeries were calculated. A sensitivity analysis was performed to provide a range for the rates of subsequent surgery. Univariate analyses consisted of chi-square or Fisher exact tests for categorical variables.ResultsIn total, 897 patients (637 who underwent closed reduction and 260 who underwent open reduction) were identified. The age-specific incidence per 100,000 population was 12.5 for closed reduction and 2.6 for open reduction for <1-year-olds, 2.2 for both closed and open reductions for 1-year-olds, 0.4 for closed reduction and 1.0 for open reduction for 2-year-olds, and <0.3 for closed reduction and 0.5 for open reduction for 3-year-olds. Overall, closed reductions were performed more frequently over the study period (p < 0.01). The estimated rate of subsequent ipsilateral surgery was 12.4% (range, 9.4% to 33.1%) after index closed reduction and was 14.2% (range, 8.5% to 40.1%) after index open reduction.ConclusionsWe found that the incidence of closed or open hip reduction for DDH was small and that there was an increase in the number of closed reductions performed over time. The rates of subsequent surgery remained relatively high for patients after index closed or open hip reduction.Level of evidenceTherapeutic Level III. See Instructions for Authors for a complete description of levels of evidence

A STUDY ON DRUG-DRUG INTERACTION BETWEEN GLIPIZIDE AND CIMETIDINE IN RABBITS

Objective: To study the effect of Cimetidine (H2 receptor antagonist) in combination with Glipizide (Sulfonylurea) on the blood sugar level in rabbits. Methods: Six albino rabbits were taken for the study. Glipizide was administrated to each rabbit as a single drug therapy on day 1 and it was co-administrated with Cimetidine to each rabbit as a combinational drug therapy on day 7. Cimetidine was administrated to each rabbit from day 2 to day 6 as single drug therapy. Blood sugar levels were estimated on day 1 and on day 7 at 0, 1, 2, 4, and 6 h. Results: The mean blood sugar level readings at 0, 1, 2, 4 and 6 h on day 1 were 90.4, 69.4, 62.9 and 65.7 mg% and on day 7 were 89.4, 74.8, 65.5, 56.4 and 61.2 mg % respectively. When mean blood sugar level on day 1 and day 7 was considered, there was a significant reduction in blood sugar level at 1, 2, 4 and 6 h and there was no significant fall in blood sugar level at 0 hour after co-administration of Glipizide and Cimetidine. Conclusion: Cimetidine, when co-administered with Glipizide, significantly increases the hypoglycaemic action of Glipizide

Prescription pattern study of antiasthmatics drugs in tertiary care centre

Background: Bronchial asthma is a social and economic healthcare burden. Drug Utilization studies can play a key role in helping the healthcare system to understand, interpret and improve the prescribing administration & use of medications.Methods: A prospective, Cross-sectional, Observational study was conducted at inpatient and outpatient Department of Medicine and Paediatrics in tertiary health care centre. As per inclusion criteria, 127 patients with asthma were interviewed, and prescription data was recorded in a pre-designed case record form from 1 October 2018 to 31 December 2018.Results: A total of 127 prescriptions were studied. It was observed that majority of the study patients were in the age group of 40-50 years, with 83 (65.5%) males and 44 (34.6%) females. Most of the patients were of Mild intermittent asthma 65 (51.18 %) followed by patients with Mild persistent asthma 31 (24.40 %). 10 different anti-asthmatics drugs were prescribed along with adjunctive medicines. Most of the patients received multiple drug therapy 98 (77.16 %). Prevalence of two drug combination was the highest 74 (58.26 %) followed by monotherapy29 (22.83 %). Most common route of drug administration was inhalational route followed by oral route. β2 agonists and corticosteroids were the most commonly prescribed combination drugs followed by methylxanthines. 103 (81.10 %) prescription contains both generic and brand drugs compared to generic names only 16 (12.59 %) and brand names only 8 (6.29 %).Conclusions: This study concluded that the present prescribing practice in asthma therapy in tertiary care centre is not sufficiently rational. Hence, it is necessary to encourage physicians to follow asthma guidelines while managing asthmatic patients

OPTIMIZATION OF MICROWAVE ASSISTED SOLVENT-FREE SYNTHESIS OF SOME SCHIFF BASES

Objective: To optimize microwave assisted solvent free synthesis of Schiff bases of aromatic aldehydes and aromatic amines (ethyl 4-aminobenzoate) by using wetting reagent ð›½-ethoxyethanol. The goal of this study was to investigate the % yields and time required for the completion of reaction for Schiff bases by microwave and conventional conditions.Methods: Schiff bases have been synthesized by condensation of substituted various aromatic aldehyde (.001 mol) with Ethyl 4-aminobenzoate (.001 mol) by two different methods as by conventional method (Heating) & Microwave accelerated synthesis by using wetting reagent ð›½-ethoxyethanol. The reaction time for conventional method and microwave method is in the range of 60-240 min and 10-180s respectively. All the synthesized compounds recrystallized & characterized by IR, NMR, and Mass and element analysis.Results: The simple microwave assisted solvent-free method for the synthesis of Schiff bases using a wetting reagent (ð›½-ethoxyethanol) led to improvement in the yield of all the target compounds with reduction in their reaction byproducts & substantially reduced the overall process time as expected as compare to traditional method. Excellent isolated yields (up to 96%) were attained within short reaction times (typically, 60s) when the reaction was performed under microwaves irradiation.Conclusion: The advantages of this environmentally benign and safe protocol include a simple reaction set-up, high product yields, short reaction times as well as the elimination of side products.Â