Drug utilization study in a neonatal intensive care unit of a government tertiary care hospital in Western Maharashtra

Background: Presently drug utilization studies (DUS) are in an evolving era. Current literature search has shown paucity of epidemiological studies in the field of paediatric pharmacology. Hence the present study was designed to assess the drug utilization pattern in neonatal intensive care unit to improvise the current prescription practices, if required and to determine areas in neonatal pharmacology in need of further research.Methods: A prospective, observational study spanned for a period of one year from January 2015 to December 2015 was conducted at the neonatal intensive care unit (NICU), Government teaching tertiary care hospital, Maharashtra. Data of prescribed drugs was collected. WHO prescribing indicators were used for evaluating DUS. Assessment of exposure rates of different class of drugs in different gestational age groups was done. Data were analysed using descriptive studies.Results: Data of 205 neonates, showed male preponderance (53.17%) over female neonates (46.83%). With regard to the gestational age, 47.31% were term, 52.68% preterm. Average number of drugs per encounter was 6.69. 76.29% drugs were prescribed by generic name and 69.80 % drugs were from IAP list of essential medicines for children. Mean drug use was 6.23±3.34 per patient. Most common class of drug to which neonates were exposed was antibiotics (96.10%) and amikacin topped the list with exposure rate of 91.22%.Conclusions: The present study substantiates the need for implementation of institutional antibiotic policies, awareness regarding IAP list of essential drugs for children, prescription by generic name and rational drug use

Serum lipid profile in non-polycystic ovary syndrome and polycystic ovary syndrome women: a comparative and correlational study

Background: Polycystic ovary syndrome (PCOS), in addition to impaired ovulation, also affects metabolic pathways. Dyslipidemia, occurring in PCOS women leads to cardiovascular diseases in them. The purpose of the present study was to compare lipid profile and its correlation with biochemical and hormonal parameters in PCOS and non PCOS women, to analyse the correlation of lipid profile with hirsutism and body mass index (BMI) in PCOS women.Methods: The present study includes 68 women divided into non PCOS groups (n=30) and PCOS (n=38) as defined by Rotterdam criteria. PCOS group further divided into overweight / obese (n=23) and normal weight subgroups (n=15). Lipid profile, fasting blood glucose and hormonal profile were done in all the groups.Results: TG and TC/HDL ratio were significantly high in PCOS group. Hirsute patients had raised LDL levels as compared to non-hirsute. LDL showed positive significant correlation with insulin, HOMA, testosterone in PCOS group. TC was significantly positively correlated with insulin and HOMA in PCOS group. In both normal weight and overweight / obese PCOS subgroups, LDL had positive and significant correlation with testosterone. TC showed positive and significant correlation with HOMA in overweight/obese subgroup. HDL showed positive and highly significant correlation with FSH in normal weight PCOS.Conclusions: Hyperandrogenism in PCOS may be additionally marked by raised LDL. Overweight/obese PCOS subgroup may be prone to dyslipidemia as well as deranged glucose homeostasis, thereby making it an important therapeutic target

A study of adverse drug reactions in patients receiving treatment for multi-drug resistant tuberculosis

Background: A high frequency of adverse drug reactions (ADRs) is one of the major challenges in the treatment of Multi-drug resistant tuberculosis (MDR-TB). Patients may refuse to continue treatment if ADRs are not properly addressed, drugs may be stopped unnecessarily and treatment may be terminated prematurely by inexperienced health workers, resulting in a high proportion of failure.Methods: Patients diagnosed for MDR-TB and registered in Drug Resistant TB centre (DR-TB) of tertiary care hospital during period of July 2014 to June 2015 were enrolled in the study. Data of patients hospitalized for the complaints of ADR in DR-TB centre during study period was collected.Results: Out of 468 patients, 60 (12.82%) patients developed at least one adverse reaction and were hospitalised for the same. Among 109 reported ADRs, Gastrointestinal upset was the most common ADR reported (5.98%) followed by psychosis (4.91%) and ototoxicity (2.99%).Conclusions: The health providers, the patients and their relatives should be sensitised about these ADRs for early detection and treatment. It can also be suggested that the setup of DR-TB centre should be integrated with psychiatry and ENT specialities, with all the provisions of early detection of ADR and treatment

Use of anti-snake venom and clinical outcomes in snake envenomation: a prospective observational study

Background: The only effective measure to prevent or reverse most of the manifestations of venomous snake-bite is timely administration of antisnake venom (ASV) with or without adjunctive treatment as necessary in each case. But recently several concerns have been raised with regard to use of polyvalent ASV. Hence the present study was conducted to assess use of ASV, early adverse reactions to ASV, adjunctive treatment and clinical outcomes in snake-bite patients, which would help to identify areas of problem and provide basis for planning strategies to increase rational use of drugs.Methods: It was a prospective observational study approved by Institutional Ethics Committee. All indoor patients with systemic manifestations of snake envenomation were included in the study. All participants gave written informed consent. Data was obtained prospectively using a structured case record form. Descriptive statistics was used to express the results.Results: Among 52 patients, snake-bite predominantly affected males (59.62%) than females (40.38%). The most common site of snake-bite was lower limb (65.38%). The main indication for ASV administration was vasculotoxic snake-bite (59.62%). Mean dose of ASV use was 18.21±15.51 vials. Mortality was seen in one patient. Majority of patients (28/52, 53.85%) received ASV in the range of 1-10 vials for the management of snake-bite.Conclusions: The use and dose of ASV was appropriate in vasculotoxic snake-bite while few neurotoxic snake-bite patients needed higher than recommended dose.

An assessment of attitudes towards plastics and bioplastics in Europe

Over the last 50 years, conventional fossil-based plastics have become an integral part of our everyday lives. Apart from their low production costs, this is due to a number of their unique properties, including durability, strength, lightness, electrical and thermal insulation, resistance to chemicals and corrosion. The production of plastics has increased from 1.5 million metric tons in 1950 to 359 million metric tons in 2018. Of this total, 61.8 million metric tons were produced in Europe. There are various problems associated with plastic use and disposal that pose a serious threat to both the physical environment and human health. Since public behaviour plays a key role when it comes to the use of plastic, this paper reports on a study that focused on an assessment of attitudes towards plastics and bioplastics in Europe. The results showed that packaging is the most frequent modality of plastic used among participants. In addition, majority of participants are aware that plastic waste can affect environment and human health and therefore segregate and properly dispose plastics. Also, even though most respondents were aware of the environmental problems related to plastic use and showed a positive inclination towards using bioplastic materials, their limited availability and lack of relevant information about bioplastics pose a problem for wider use. Departing from the assumption that the public attitude is a determining factor in the consumption of plastics as a whole and bioplastics in particular, this paper also sheds some light on the current situation, identifying some trends and information gaps which should be addressed in order to encourage a more rational use of plastics in Europe

Morbidity profile of ex-servicemen residing in Sangli-Miraj-Kupwad municipal corporation area and its relationship with certain clinico-epidemiological factors

Research Question: What is the morbidity profile of ex-servicemen residing at Sangli-Miraj-Kupwad corporation area. Objectives: 1) To determine types and extent of prevalent morbidities among ex-servicemen. 2) To ascertain the association between prevalent morbidities and selected predictor variables Study Design: Cross-sectional study. Setting: Ex-servicemen′s canteen, Vishrambag, Sangli. Participants: 416 ex-servicemen, registered under ex-servicemen′s canteen, Vishrambag. Statistical Analysis: Percentage, Chi-square test, and odds ratio. Results: 214 (52.16%) subjects had one or more diseases/conditions. Commonest diseases detected were hypertension (26.20%), musculoskeletal problems (23.55%), and mental health problems (12.98%). Increase in the post-retirement period of ex-servicemen was significantly associated with increase in prevalence of hypertension, OR = 10.88 (4.54-26.52) and musculoskeletal disorders, OR = 8.75 (3073-20.52). Prevalence of hypertension was significantly more for those who served less than 10 years in the military job, OR = 1.90 (1.04-3.8). In the upper socio-economic class, the risk of hypertension was significantly more, OR = 6.08 (1.78-20.17); in the upper lower class, the risk of musculoskeletal disorders was significantly more, OR = 4.15 (1.88-9.16). Considering the importance of health of ex-servicemen and existence of high morbidity pattern, periodical screening was needed for every ex-serviceman who belonged to the high-risk group

Case Report Congenital Thrombotic Thrombocytopenic Purpura: An Unusual Case of Microangiopathic Haemolytic Anaemia in a Newborn

ABSTRACT We present an extremely rare case of hyperbilirubinemia with rapid progression leading to bilirubin encephalopathy in term neonate. Despite early recognition and intervention, death occurred as a total serum bilirubin reached 25 mg/dl. It was a case of Coomb's negative microangiopathic haemolytic anaemia in a newborn period which is autosomal recessive inheritance i.e. Upshaw-Schulman Syndrome. (Congenital thrombotic thrombocytopenic purpura) characterised by numerous schistocytes on peripheral blood smear, thrombocytopenia , increased reticulocyte count, increased bilirubin and LDH level. This rare disease is often misdiagnosed especially in newborn baby. So we present this case not only for its variety but also for to create more awareness among pathologist and paediatrician as treatment protocol entirely differ