Pattern of drug utilization in pediatric out patient department of a tertiary care teaching hospital

Background: Drug utilization studies have special significance among paediatric age groups as infant and children represent about 42% of the population in developing countries. This is the vital period of rapid growth and development. Therefore, drugs should be used very cautiously and rationally among these sub groups. The present study is conducted to analyse the prescribing pattern of drugs in paediatric age group for various illnesses. Methods: It was a prospective observational study, conducted in paediatric outpatient department of Raja Rajeswari medical college and research hospital for a period of 6 months after obtaining approval from institutional ethical committee. Descriptive statistical was used to determine the frequency, percentages, mean and standard deviation.Results: In the present study, fever (30.8%) followed by respiratory diseases were most common diseases seen. The commonly used drugs include antipyretics (66%), antimicrobials (53.6%), cough syrups (34.4%), antihistaminic (31.2%) and nasal decongestants (23.2%). Prescribing indicator shows existence of polypharmacy. Prescribing drugs by generic name was seen only in 8.1% and 47.82% of the drugs were prescribed from EDL. The frequency of use of injectables in our study was 5.8%. Conclusions: Irrational use of antibiotics and polypharmacy needs to be curbed. Prescribing drugs in their generic name and prescribing drugs from EDL need to be promoted. The present prescribing pattern can be improved by advocating rational drug prescribing, patient education and improving hospitals

Study on assessment of awareness about concepts in undergraduate pharmacology curriculum among clinicians in a tertiary care teaching hospital

Background: Rational prescribing forms the corner stone of successful implementation of rational drug use. To boost the cause of rational use of Medicine, the P-drug concept was given in late nineties. The idea was to make Physicians familiar with few personal drugs chosen from National Essential drug list based on efficacy, safety, suitability and cost. The present study was conducted to assess the awareness of clinicians about basic pharmacological concepts.Methods: It is a cross sectional study with a study population of 100, conducted in RRMCH for a period of one month. It is a questionnaire based study involving clinicians and post graduates working in this hospital. Descriptive statistical analysis has been carried out in the present study.Results: In our study, 38% of physicians were aware of the term Essential drugs and 26% of doctors prescribed drugs from National Essential drug list. 56% of respondents were aware of term rational drug use but only 1/3 of them were aware of adverse effects, drug interactions of the drugs they prescribed. Majority of physicians (85%) used standard text book as the source of drug information.Conclusions: Lack of knowledge among physicians about new concepts like p-drug, rational drug use and essential drugs points towards need for having more CMEs on basic pharmacological concepts

Study on antihyperglycemic effect of bromocriptine in dexamethasone induced hyperglycemic wistar rats

Background: Diabetes mellitus is a chronic metabolic disorder that develops due to insulin deficiency or insulin resistance. Recent animal and human studies have reported bromocriptine to be effective in the management of type 2 diabetes mellitus. The present study was done to evaluate the antihyperglycemic effect of bromocriptine in dexamethasone induced hyperglycemic rats.Methods: Male wistar rats were used and divided into 5 groups. Dexamethosone was used to induce hyperglycemia in group B-E. Group A was the untreated control group, group B was the standard control group, group C was the oral 10 mg/kg of bromocriptine dissolved in 0.9% normal saline, group D was the oral 20 mg/kg metformin dissolved in 0.9% normal saline, group E was the oral 10 mg/kg bromocriptine+20 mg/kg metformin dissolved in 0.9% normal saline. Fasting blood glucose, post prandial blood glucose and body weight was estimated on day 1, 15, 30.Results: It was seen that dexamethasone induced hyperglycemia and increase in body weight in male wistar rats, which were significantly controlled by oral bromocriptine and bromocriptine with metformin combination.Conclusions: Results obtained from this study showed that bromocriptine can be a promising drug with novel mechanism to treat type 2 diabetes mellitus

Intravenous paracetamol infusion versus intramuscular tramadol as an intrapartum labor analgesic

Background: The objective of the study was to compare intravenous paracetamol and intramuscular tramadol as labor analgesics.Methods: This prospective-randomized study conducted in 200 primigravidae in active labor, distributed into two groups of 100 women each with one receiving intravenous 1,000 mg Paracetamol and other 100 mg intramuscular tramadol. Pain intensity is recorded by McGills scale before, one and 3 h after drug administration. Perinatal outcome is recorded.Results: No difference in pain intensity is seen before drug administration. After 1 h of drug administration, in paracetamol group, 4 % women had horrible pain, and 28 % had distressing pain, while in tramadol group, 30 % women had horrible pain, and 60 % had distressing pain. After 3 h of drug administration, in paracetamol group, 26 % had distressing pain, while in tramadol group, 50 % women had horrible pain, and 36 % had distressing pain. Labor duration in paracetamol and tramadol group was 4.6 and 6.0 h, respectively. In paracetamol group, nausea is seen in 2.2 % and vomiting in 1.1 %, while in tramadol group, nausea is seen in 6.4 % and vomiting in 4.3 %.Conclusions: Intravenous paracetamol is more effective labor analgesic with fewer maternal adverse effects and shortens labor as compared to intramuscular tramadol

Role of leutenising hormone LH and insulin resistance in polycystic ovarian syndrome

Background: Polycystic ovary syndrome (PCOS) is the most frequent endocrine disorder seen in pre-menopausal women, affecting 5-10% of this population. It is characterized by menstrual irregularities and clinical hyperandrogenism such as hirsutism, seborrhoea and acne. PCOS women have insulin resistance, which results in compensatory hyperinsulinemia. A number of findings suggest that hyperinsulinemia may play a central role in the development of hyperandrogenism. This study is under taken to measure insulin resistance and leutenising hormone (LH) in PCOS patients and to see the relationship of insulin resistance with leutenising hormone (LH).Methods: Case control study was done taking 60 women PCOS and 60 age matched healthy women as controls. In all the subjects, concentrations of fasting plasma glucose estimated using enzymatic methods in semiautoanalyser. Fasting serum insulin and leutenising hormone (LH) measured by CLIA using Lumax-CLIA microplate reader. HOMA IR was calculated from estimated parameters.Results: The concentration of fasting serum insulin,fasting plasma glucose,HOMA –IR and leutenising hormone(LH) in controls are 9.33±3.08 µIU/ml,94.38±10.36mg/dl,12.16±0.67and 4.67±1.94 mIU/ml respectively; in PCOS cases they are 24.50±10.03µIU/ml,114.20±30.38 mg/dl,7.29±4.08 and 15.75±7.51 mIU/ml respectively. The mean concentrations of all the parameters were significantly (p value<0.05) increased in women with polycystic ovarian syndrome when compared with healthy women.Conclusions: This study shows that 75% of pcos women were insulin resistant and HOMA IR shows a positive correlation (r value 0.48, p<0.05) with serum leutenising hormone(LH)

PPIUCD versus interval IUCD (380a) insertion: a comparative study in a referral hospital of Karnataka, India

Background: Comparative evaluation of PPIUCD and interval IUCD in terms of incidence of failure, expulsions, bleeding p/v and other complications.Methods: Total 200 willing women after counseling in antenatal, early labour or post natal were inserted PPIUCD after excluding chorioamnionitis, PROM >18hrs, unresolved PPH, puerperal sepsis. Another 100 willing women were inserted interval IUCD after excluding contraindications. All were followed up to 6 months.Results: Expulsions rate was significantly higher in PPIUCD as compared to interval insertions (5.5% v/s 5%). Number of removal of IUCD was almost similar in both the groups (6.5% V/S 7%). Common causes of PPIUCD removal were social.Conclusions: Postpartum inserting of IUCD is safe effective, feasible and reversible method of contraception

Genetic Correlation and Cluster Analysis in Sapota (Manilkara zapota)

Sapota is classified into two main types based on fruit shape as 'round' and 'oval'. However, there are several intermediates, as, it is a heterozygous tree crop. In this study, an effort was made to group available variability in sapota based on fruit characters and to analyze it. This helps in selection of parents for use in further breeding programmes. Cluster analysis revealed four definite clusters. High variability was observed for fresh-fruit weight, fruit length, fruit girth, fruit weight at ripening, pulp weight, peel weight, number of seeds and TSS. Correlation studies among fruit parameters indicated positive relationship between all the parameters studied, except TSS which had negative relationship with the rest of the fruit parameters. Selection of distantly placed cultivars in breeding programs stands to result in better progeny for further evaluation

Genetic system for project support with the sequencing problem

One of the main problems faced by manufacturing companies in the production sequencing, also called scheduling, which consists of identifying the best way to order the production program on the machines for improving efficiency. This paper presents the integration of a simulation model with an optimization method to solve the problem of dynamic programming with stochastic demand

Comparison of Doppler findings and neonatal outcome in fetal growth restriction

Background: Fetal growth restriction (FGR) affects up to 5-10% of pregnancies. It is associated with increased perinatal mortality and morbidity. Doppler studies identify at risk fetuses and help in timing interventions and prognosticate outcomes. The ability of Doppler studies to predict neonatal outcome is studied here.Methods: Prospective study of seventy-two women with singleton pregnancies with gestational age above 28 week and detected to have FGR was done. The patients were subjected to Doppler analysis. Abnormal Doppler indices were compared with neonatal outcomes such as NICU admission, ventilator or CPAP support, sepsis, phototherapy and perinatal mortality.Results: Elevated umbilical artery PI, reduced middle cerebral artery PI and low CP ratio were found in 14, 18 and 36 fetuses. The sensitivity and specificity in predicting neonatal outcome was 25% & 75%, 58.1% and 62% and 17.9% and 75% for umbilical artery PI, MCA PI and CP ratio respectively. None of the Doppler indices showed significant p value. On testing, gestational age at delivery and length of NICU stay, gestational age was a significant determining factor with ‘p’ value of 0.003.Conclusions: Antenatal Doppler analysis of UA and MCA can predict neonatal outcome in FGR fetuses. Though the ‘p’ value was not significant in this study, the sensitivity, specificity, positive predictive value and negative predictive value are comparable to other studies. Gestational age at delivery significantly influences neonatal outcome

Triple Band Textile Array Antenna with Enhanced Gain and Low SAR for Off Body Communication Applications

A triple band wearable microstrip patch antenna array has been designed and analyzed in this work. The designed antenna can be operated in ISM, LAES and X-Band with moderate average gain of 4.2 dB. The antenna gain has been improved by constructing array structure of 1X2 and 1X4 with good impedance feeding by quarter wave transformer. The proposed array antennas are providing moderate gain of 5.7 dB (1X2) and 8.3 dB (1X4) with efficiency more than 90% in the operating bands. The antenna model and the array has been constructed on wearable substrate with conductive textile as radiating element in the design for off body wearable communication applications. SAR analysis also providing acceptable values below 1.6 w/kg at triple operating bands with body placement experimentation. &nbsp