A study of drug utilisation pattern in patients of chronic kidney disease at a tertiary care hospital

Background: Chronic kidney disease (CKD) is a major public health issue and widely prevalent non-communicable disease in India. CKD has a complex pharmacotherapy and it inevitably requires poly-pharmacy. CKD patients require to take medications for a lifelong period, which makes it very important to study the prescribing trends on a regular basis. The main objective of the study was to analyse current prescribing trends in the management of CKD patients and to know whether the prescribing rationality was maintained.Methods: After Institutional Ethics Committee approval, a prospective         Cross-sectional study was carried out at Nephrology department of a tertiary care hospital for a period of six months from 1st June 2017 to 30th November 2017. Patients diagnosed with CKD by treating Nephrologist were included and their prescriptions were analysed to study the prescribing patterns.Results: A total of 120 cases were analysed during the study, of which 81.7% were males and 18.3% were females. Analysis of WHO core drug prescribing indicators showed that the average number of drugs prescribed per patient was 5.13, percentage of drugs prescribed by generic name was 30.03%, percentage of patients with an injection prescribed was 16.6%, percentage of drugs prescribed from essential medicine list was 65.8% and percentage of patients prescribed with an antibiotic was 10.8%. Antihypertensive drugs (39.9%) were the most commonly used drugs, followed by, calcium salts (12.01%), multi-vitamins (7.6%), oral iron supplements (6.8%), erythropoietin (6.3%) and ulcer protectives (6.1%).Conclusions: Maximum number of drugs were prescribed from cardiovascular class of drugs. Calcium channel blockers and diuretics were the commonest group of antihypertensives prescribed. The principle of rational prescribing was followed

Potential drug-drug interactions among hospitalized cardiac patients

Background: Drug-drug interactions (DDIs) are a major cause for concern in patients with cardiovascular disorders due to multiple co-existing conditions and the wide class of drugs they receive. The objective of our study was to identify potential drug-drug interactions among hospitalized cardiac patients and to identify the risk factors associated with these interactions.Methods: After obtaining approval from Institutional Ethical Committee, a prospective observational study was carried out among 367 hospitalized cardiac patients in Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysuru. Cardiac patients prescribed at least 2 drugs and having hospital stay of more than 24 hour duration were enrolled into the study. The prescriptions were analysed for potential DDIs using MEDSCAPE multidrug interaction checker tool. Descriptive statistics, Student ‘t’ test, ANOVA and Pearson correlation coefficient were used to analyse the results.Results: The incidence of potential DDIs was 98% with 360 prescriptions having at least one potential DDI. A total of 38 potentially interacting drug pairs were identified among which majority were of significant grade while only 3 were serious. Majority of interactions were pharmacodynamic (76.3%) in nature. Aspirin/clopidogrel (71.1%) and pantoprazole/clopidogrel (69.8%) were the most common interacting pairs. Drugs most commonly involved were aspirin, clopidogrel, heparin, pantoprazole and ramipril. Age, female gender, polypharmacy, prolonged hospital stay, stay in ICU and diabetes mellitus were the risk factors found associated with the potential DDIs.Conclusions: Proper therapeutic planning, routine monitoring of cardiac in-patients and usage of online DDI database will avoid potentially hazardous consequences in cardiac in-patients

Clinico-epidemiological study of topical steroid dependent face in a tertiary care hospital at Mysore

Background: Topical steroids are the most commonly prescribed drugs in dermatology. The adverse effects of steroid misuse are noticeable 3 to 4 weeks after application. Steroid rosacea, hypertrichosis and acneiform eruptions are few of them. A new entity known as topical steroid dependent face, topical steroid dependent face (TSDF) has been recently coined to encompass symptoms such as erythema, burning sensation on attempted cessation of topical steroid application.Methods: A questionnaire-based analysis was done among patients attending dermatology outpatient department of government medical college hospital, Mysore between November 2018 to May 2019. Prior approval of the institutional ethics committee, and consent of patients were obtained. A total of 200 outpatients with facial dermatosis using topical steroids on face for a period greater than one month were taken up for study.Results: The results included population across different age groups, between 16 to 60 years. 56% belonged to the age group of 16 to 30 years. Most common steroid abused was mometasone cream 0.1% (50%), betamethasone valerate cream 0.1% (24.5%) followed by clobetasol ointment 0.05% (21.5%). The major adverse effect with steroid abuse, were acne 72% facial redness 67%. Hyperpigmentation 51%, hypertrichosis 32.5% and skin atrophy 21%.Conclusions: The present study highlights and creates awareness on the burden of facial topical steroid abuse and the poor attitude towards them

A comparative study between intramuscular oxytocin and intramuscular methyl ergometrine in the active management of third stage of labour

Background: To compare the efficacy of prophylactic IM oxytocin 10U and IM methyl ergometrine 0.2mg on duration of third stage of labour, amount of blood loss during the third stage of labour and associated side effects.Methods: 50 low risk antenatal women with singleton pregnancy at term gestation in vertex presentation admitted for vaginal delivery, were randomly allocated into 2groups of 25 each and managed actively in the third stage of labour either with 10 U oxytocin IM or with 0.2mg methyl ergometrine IM immediately after the birth of the baby. The main outcome measures were the difference between the 2groups with regard to: duration of third stage of labour, blood loss by volume, difference in haemoglobin and haematocrit, need for blood transfusion, additional uterotonics and side effects of drugs.Results: The mean duration of third stage of labour in the oxytocin group was 6.68±2.17min and in methergine group was 6.4±1.93 min. Mean blood loss was 302±75.6ml and 282.8±58.27ml. Mean fall in Hb was 0.92gm% and 0.812gm%. Mean fall in PCV was 2.36% and 1.88%. 2women in oxytocin group and 1woman in methergine group received additional 0.2mg methergine. 3women in both groups received 1unit of blood transfusion. 8women who received methergine had side effects while only one in the oxytocin group, with a p value 0.004 which is statistically significant.Conclusions: This study has shown that both oxytocin and methylergometrine were equally efficacious. However, oxytocin had significantly better safety profile and lesser contraindications for usage

Dispersal of Egyptian Vultures Neophron percnopterus: the first case of long-distance relocation of an individual from France to Sicily.

Knowledge of juvenile dispersal is important for understanding population dynamics and for effective conservation, particularly of geographically isolated raptor populations. Here, we report the first documented case of a long-distance movement of an Egyptian Vulture Neophron percnopterus from the French population to Sicily. This observation opens a new perspective for the conservation of the small and endangered Sicilian population of this species, providing evidence that persistence of the Italian population may be aided by new input from other countries

Decoding the X-ray flare from MAXI J0709-159 using optical spectroscopy and multi-epoch photometry

We present a follow-up study on the recent detection of two X-ray flaring events by MAXI/GSC observations in soft and hard X-rays from MAXI J0709-159 in the direction of HD 54786 (LY CMa), on 2022 January 25. The X-ray luminosity during the flare was around 10^(37) erg/s (MAXI), which got reduced to 10^(32) erg/s (NuSTAR) after the flare. We took low-resolution spectra of HD 54786 from HCT and VBT facilities in India, on 2022 February 1 and 2. In addition to H-alpha emission, we found emission lines of He I in the optical spectrum of this star. By comparing our spectrum of the object with those from literature we found that He I lines show variability. Using photometric study we estimate that the star is having effective temperature of 20000 K. Although HD 54786 is reported as a supergiant in previous studies, our analysis favours it to be evolving off the main sequence in the Color-Magnitude Diagram. We could not detect any infrared excess, ruling out the possibility of IR emission from a dusty circumstellar disc. Our present study suggests that HD 54786 is a Be/X-ray binary system with a compact object companion, possibly a neutron star.Comment: 9 pages, 5 figures, 1 table, accepted for publication in ApJ

Entomologie.

Les principaux rabageurs de la culture cotonnière du C-4; Suivi des ravageurs dans l'écosystème et prise de décision; Méthodes de lutte intégrée; Lutte variétale; Contrôle chimique et techniques d'application; Techiques d'appliction des produits.bitstream/item/142479/1/Entomologie.pdfCOTON-4. Idioma: Francês e Português