A study on histopathological examination of colorectal carcinoma with special reference to expression of CK20 in colorectal adenocarcinoma at a tertiary care centre

Background: Colorectal carcinoma is the third most common cancer worldwide, over 1.8 million new cases are estimated in the year 2018. In terms of mortality, colorectal carcinoma ranks second with estimated 881,000 deaths in 2018. Histopathological study plays a central role for diagnosis and definitive treatment of colorectal carcinoma. In present time, immunohistochemical markers with adjunct to morphology helps in diagnosis and also in prognosis and treatment. Therefore, in colorectal carcinoma, along with morphology, many such immunohistochemical markers are being studied.Methods: This study was carried out in the Department of Pathology at a tertiary care health centre in the southern part of Assam for a period of 1 year from June 2018 to May 2019. 52 cases of colorectal carcinoma diagnosed by histopathological study were included in the study. All patients were analysed for age, gender, type of growth and location of growth. Immunohistochemical staining of cytokeratin (CK) 20 was done and expression was studied and correlated with age, location of tumour, grade and tumour stage.Results: Out of total 52 patients, 33 were male and 19 were female. Average age of presentation was 48.46±15.51 years. On gross examination rectal tumours were the most common and maximum tumours had polypoidal type of growth. On immunohistochemical study CK20 expression was detected in 82.7% out of 52 cases of colorectal adenocarcinoma and negative in 17.3% cases.Conclusions: The correlation between CK20 expression and grading and tumour stages of colorectal adenocarcinoma was statistically significant. Further, large scale population-based studies with more number of cases and follow-up of these cases need to be done for better assessment of this immunohistochemical marker in colorectal adenocarcinoma that can be used for assessment of prognosis.

A study on the usage of antimicrobial agents and adverse drug reaction of antimicrobial used in a tertiary care hospital in North East India

Background: Irrational use of antimicrobial agents (AMAs) has led to large scale development of drug resistance and adverse drug reactions (ADRs) which has become a growing world -wide concern. The study was conducted to analyze the prescribing pattern of AMAs and to evaluate the reported ADR of the AMAs prescribed.Methods: A prospective study was conducted by analyzing 900 case sheets receiving AMAs in a tertiary care hospital. The study plan included analysis of average number of AMA prescribed, morbidity profile of patients, types of AMAs used, drug prescribed by generic/brand name, injectable AMA preparations and appropriateness of indication of AMA used. Thirty reported cases of ADR were evaluated for their casualty by Narnajo’s scale and severity by Hartwigs scale.Results: Average number of drugs per prescription was 1.54. Most common morbidity was fever due to various causes. 86.2% of AMA used was antibiotics. About 72.0% of AMAs were prescribed by generic name. Percentage of injectable preparation was 85.0%. 65.0% of drugs were prescribed from Essential drug list (EDL). Most offending drug for ADR was fixed drug combination (FDC) 30.0%. Common organ system involved was skin (63.3%). Most of the ADR were possible (80.0%) and mild (76.6%) in nature.Conclusions: Average number of AMAs per prescription was1.54. Percentage of drug prescribed by generic name is encouraging. However use of injectable preparation was very high. Majority of AMAs prescribed were antibiotics which is also very high. Periodic prescription audit will provide feedback to the prescribers and help in reducing the prescribing error and ADR cases

To study the pattern of suspected adverse drug reactions in patients coming to the department of dermatology in Gauhati Medical College and Hospital, Guwahati, Assam, India

Background: Cutaneous adverse drug reactions (ADRs) are the commonest ADRs (30-45%) and are responsible for about 2% of hospital admissions. This study was conducted to study the pattern of ADRs coming to the department of dermatology in a Tertiary Health Care Hospital. The objectives of the study were to assess the causality, severity, preventability, age distribution, sex distribution and the reactions occurring.Methods: Cross-sectional study. The suspected adverse drug reactions (ADRs) reported from the department of dermatology in the Spontaneous ADR reporting form was analysed in this study over a period of one year.Results: A total of 513 cases of reported ADRs were analysed. The highest number of ADRs was reported in the Age group 21-40 years with female preponderance. Erythematous maculopapular lesions were the most common ADR and maximum cases of ADRs were observed with steroids. Most cases were found to be probable (causality assessment), of mild severity and were probably preventable.Conclusions: The study showed that a number of drugs cause dermatological ADRs. These ADRs vary in their appearance, duration, causality, severity, and preventability

A study on adverse drug reactions in a tertiary care hospital of Northeast India

Objective: Purpose of this study was to monitor adverse drug reactions reported from various departments of a tertiary care hospital in Northeast India. Reported adverse drug reactions were analysed for causality and severity assessment.Methods: This cross sectional study was conducted in a tertiary care hospital at Guwahati, Northeast India, for 7 months. Patients of all age and either sex were included. Adverse drug reactions were reported by the physicians of this hospital and their causality and severity assessments were performed as per Naranjo’s and Hartwig’s assessment criteria respectively. Descriptive statistics were used for data analysis.Results: Total 255 adverse drug reactions were reported from various departments of this tertiary care hospital. Most of the adverse drug reactions were observed in the age group of 21–30 year. Acne (46) was commonly reported reaction. Topical steroids, betamethasone sodium phosphate and clobetasol were reported to induce maximum number of reactions (59). Skin (227, 66.9%) was commonly affected organ system. Most of the adverse drug reactions were possible (240, 94.1%) and mild (222, 87%) in nature.Conclusions: The topical steroid (betamethasone sodium phosphate) was reported to induce adverse drug reactions in majority of the patients. The commonly reported reaction was acne.Keywords: ADRs; Northeast; Naranjo; Hartwig; Pharmacovigilanc

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

A study on the usage of antimicrobial agents and adverse drug reaction of antimicrobial used in a tertiary care hospital in North East India

Background: Irrational use of antimicrobial agents (AMAs) has led to large scale development of drug resistance and adverse drug reactions (ADRs) which has become a growing world -wide concern. The study was conducted to analyze the prescribing pattern of AMAs and to evaluate the reported ADR of the AMAs prescribed.Methods: A prospective study was conducted by analyzing 900 case sheets receiving AMAs in a tertiary care hospital. The study plan included analysis of average number of AMA prescribed, morbidity profile of patients, types of AMAs used, drug prescribed by generic/brand name, injectable AMA preparations and appropriateness of indication of AMA used. Thirty reported cases of ADR were evaluated for their casualty by Narnajo’s scale and severity by Hartwigs scale.Results: Average number of drugs per prescription was 1.54. Most common morbidity was fever due to various causes. 86.2% of AMA used was antibiotics. About 72.0% of AMAs were prescribed by generic name. Percentage of injectable preparation was 85.0%. 65.0% of drugs were prescribed from Essential drug list (EDL). Most offending drug for ADR was fixed drug combination (FDC) 30.0%. Common organ system involved was skin (63.3%). Most of the ADR were possible (80.0%) and mild (76.6%) in nature.Conclusions: Average number of AMAs per prescription was1.54. Percentage of drug prescribed by generic name is encouraging. However use of injectable preparation was very high. Majority of AMAs prescribed were antibiotics which is also very high. Periodic prescription audit will provide feedback to the prescribers and help in reducing the prescribing error and ADR cases

A review of the thermal performance parameters of box type solar cookers and identification of their correlations

One of the many thermal performance parameters such as efficiency, cooking power, figures of merit etc. are used to evaluate a solar cooker (including box type) based on test procedures which are non-identical. In the absence of an interrelation between the different performance parameters, it is very difficult to compare the cookers' performance reported by different researchers and establish the criteria required for selection of a cooker which can accomplish cooking successfully and satisfactorily. In this review paper, some of the performance parameters and the related test procedures have been reviewed for box type solar cooker. Further an attempt has been made to identify common links between the different performance parameters in terms of a few objective parameters. This provides an enabling tool to the researchers to compare and correlate the different performance parameters. Three such objective parameters have been identified for box type solar cookers.Thermal performance parameters Objective parameters Box type cooker Figures of merit Cooking power