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A retrospective study of snake bite envenomation in a tertiary care teaching hospital in Southern India

Background: Snake bite is an important occupational and rural hazard because India has always been a land of poisonous snakes. In southern India common poisonous snakes are Russell’s viper, Cobra, Krait and Saw Scaled Viper. It is a fact that despite of significant morbidity and mortality, very little attention is paid by the clinicians to this occupational hazard. The objective of the present study was undertaken with the objectives of assessing poisonous snake envenomation, ASV use, Dosage of ASV and clinical outcomes in snake bite victims.Methods: This is a Retrospective study of snakebite victims from November 2013 to April 2015 in a tertiary care teaching hospital in Tamil-Nadu.Results: A Total of 82 cases were studied in our hospital. Out of these 82 Poisonous bites, 42 (51.22%) cases were viper bites, 20 (24.39%) cases were unidentified poisonous bites, 16 (19.51%) cases were Krait, and 4 (4.88%) cases were Cobra. Coagulopathy, cellulitis, wound infection, renal failure and respiratory paralysis were the common complications. Average dose of ASV administered range from 8.57 (± 0.98) to 20.78 (± 4.18) Vials. An increase in mortality, ASV dose and complications were directly proportional to the Bite to ASV Administration time.Conclusions: Delay in hospitalization is associated with poor prognosis and increased mortality rate due to complications. There is an emergent need of awareness among the community for avoidance of traditional form of treatment and delay in early medical interventions.

DRUG UTILIZATION EVALUATION OF ANGIOTENSIN RECEPTOR BLOCKER (ARB) ALONG WITH THEIR ADRS IN A TERTIARY CARE HOSPITAL

Objective: To evaluate the drug utilization of Angiotensin Receptor Blocker (ARB) along with their ADRs in a tertiary care hospital. And to monitor, report of adverse drug reaction and drug interactions, if any. Methods: The patients who meet the inclusion and exclusion criteria were enrolled into the study. The pertinent data such as demographic details, drug name, dose, frequency, and laboratory data were gathered from medical records of the patient and results were analyzed. Results: Total of 100 patients were included in this study, the maximum utilization of antihypertensive drug (ARB) was telmisartan (90%) and widely use of ARBs in the age group of 41-50 y. Total 32 ADRs were observed and most probable ADRs included headache (42.8%), Nausea (14.28%) and dizziness (12.5%). Conclusion: Telmisartan was the most prescribed and utilized drug than the other drugs of ARBs. Maximum ADRs were noted in females, the most frequent ADRs headache, nausea and dizziness were reported. The majority of reactions were probable on causality assessment done by WHO-UMC and Naranjo’s scale having mild severity. So it can be concluded that considering risk factors, prevention and management of ADRs can drastically improve the therapeutic outcomes of the patients

A retrospective study of paradigm and outcome of acute poisoning cases in a tertiary care teaching hospital in Southern India

Background: Acute poisoning is a medical emergency. It is important to know the nature, outcome and severity of acute poisoning cases in order to make appropriate prevention and   treatment. This study is conducted to assess the paradigm and outcome of acute poisoning cases in a tertiary care hospital in Tamilnadu.Methods: This is a retrospective study conducted in a tertiary care hospital in Tamilnadu. The study included 169 cases and data regarding age, sex, time elapsed after intake, name of the poisons, chemical type; duration of hospital stay; outcome and severity were collected in the structured proforma.Results: Incidence was high among males (60.36%) compared to females (39.64%). Most of the cases of acute poisoning were in the age group 10 to 30 years (60.95%) followed by 30 to 50 years age group (30.77%). A majority of poisoning cases (27.2%) were due to organophosphorus (OPC) insecticide. Total mortality was found to be 5.32%. Mortality rate due to Paraquat, Abrus Pretorius seeds was significantly high compared with OPC because there is no specific antidote. Time lapse had a very significant role in the mortality in cases of poisoning.Conclusions: Poisoning is common with young males. The mortality is high, in cases of self-poisoning with parquet and abrus seeds. Despite the highest consumption rate, no mortality was observed with organophosphorus because of early medical intervention and specific antidote. Early medical care in a tertiary care hospital will help to reduce significant mortality in India.

DRUG UTILIZATION BASED ADRs DETECTION OF ANTIBIOTICS PRESCRIBED FOR LRTI IN TERTIARY CARE TEACHING HOSPITAL, NEW DELHI

Objective: Aim of to present study was to assess drug utilization pattern of antibiotics use in Lower respiratory tract infection and their adverse drug reaction assessment.Methods: The present study was an observational and prospective study. 110 patients fulfill the inclusion criteria were included in study. Physician prescription records, patient's medication profile types of antibiotics prescribed were recorded and analyzed.Results: Out of 110 LRTI patients, 74 (67.27%) patients were male and 36(32.72%) patients were female. 72 patients were suffered from bronchitis while 38 patients were suffering from pneumonia. 30 patients were in the age range of 56-65 y, followed by 21 patients who were in the age range of 66-75 y. It has been observed that among all the prescribed antibiotic agent's frequency of β-lactam 199(45.53%), quinolones115 (26.27%), macrolides 53(12.12%) chloramphenicol44 (10.06%) sulphonamide 17 (3.89%) and aminoglycosides 9(2.05%) were prescribed to all the patients. Average 3.97 antibiotic agents were prescribed to all the patients. Majority of drugs were given by oral route (68.19%) and Prescriptions are mainly ordered in brand names. The most frequent co-morbid condition was found to be diabetes mellitus (25.45%) followed by hypertension (16.36%) and coronary artery disease (11.81%).45.45%. Only 23 ADRs were detected in 110 patients. The most common culprit was an amoxicillin with clavulanic acid.Conclusion: The present study provides an overall pattern of antibiotic usage in different patients. The area of concern in the present study is polypharmacy and use of antibiotics in LRTI without following any guideline. ADRs monitoring is also required to prevent noxious effects of drugs by the use of antibiotics

Market segment evaluation and selection based on application of fuzzy AHP and COPRAS-G methods

Market segment evaluation and selection is one of the critical marketing problems of all companies. This paper presents a novel approach which integrates fuzzy analytic hierarchy process (FAHP) and COPRAS-G method for market segment evaluation and selection. Fuzzy AHP is used to calculate the weight of each criterion, and COPRAS-G method is proposed to prioritize market segments from the best to the worst ones. The application of fuzzy set theory allows incorporating the vague and imprecise linguistic terms into the decision process. This study can be used as a pattern for market segment selection and future researches. A case study on a chair manufacturing company is put forward to illustrate the performance of the proposed methodology. First published online: 14 Sep 201

Harlequin colour change

Harlequin colour change (HCC) is a rare, benign and transient colour change presenting in normal healthy neonates in initial days of life and resolves spontaneously. It is thought to be due to hypothalamic immaturity, leading to capillary bed dysregulation. Gravity might also play a role, as this is apparent on the dependent side. It is important for physicians to recognize this phenomenon so that they do not order any irrelevant investigations. Here, we present a case of a healthy neonate who had HCC, which was unilateral, well demarcated erythema, with patchy pallor. Baby was vitally stable at that time. This colour change was observed twice and each time resolved within 20 minutes of its appearance and was not observed again to date (after 20 days). Baby was discharged in a stable condition after 48 hours of life

ODABIR MANAGERA KONTROLE KVALITETE NA OSNOVI AHP-COPRAS-G METODA: SLUČAJ U IRANU

Due to the increasing competition of globalization and fast technological improvements and world markets, demands of companies to have professional human resources are increasing too. It is an important problem of an organization to select the most appropriate personnel among the candidates. Quality control manager is important personnel in organizations and it’s so important to select the best candidate for this work. In this paper we proposed a personnel selection system based on Analytic Hierarchy Process (AHP) and Complex proportional assessment of alternatives with grey relations (COPRAS-G) method. At first seven criteria is identified including: knowledge of product and raw material properties, Experience and educational background, Administrative orientation, Behavioral flexibility, Risk evaluation ability, Payment and Team work and after that AHP applied for calculating weight of each criteria and finally using COPRAS- G method for selecting the best candidate for this job. This study can be used as a pattern for personnel selection and future researches.S obzirom na rastuću konkurentnost u globalizaciji te brzim tehnološkim napredovanjem na svjetskom tržištu, zahtjevi kompanija za profesionalnim kadrom se također povećavaju. Vrlo je važno za organizaciju biti u mogućnosti odabrati najbolji i najprimjereniji kadar među ponuđenim kandidatima. Manager kontrole kvalitete je važan kadar u bilo kojoj organizaciji tako da je iznimno važno za taj posao odabrati najbolje kandidate. U ovom radu predlažemo sustav odabira kadra zasnovan na analitičkom hijerarhijskom procesu (AHP) i kompleksnoj proporcionalnoj evaluaciji alternativa sa sivim odnosima (COPRAS-G). Isprva je identificirano sedam kriterija uključujući: znanje o proizvodu i svojstvima sirovine, iskustvo i obrazovanje, snalaženje s administracijom, fleksibilnost u ponašanju, sposobnost procjene rizika, plaćanja i timski rad te je zatim primijenjen AHP za izračunavanje težine svakog kriterija te je naposljetku korištena COPRAS-G metoda za odabir najboljih kandidata. Ova studija se može koristiti kao predložak za odabir kandidata i buduća istraživanja

Planning the priority of high tech industries based on SWARA-WASPAS methodology: The case of the nanotechnology industry in Iran

Decision-making and planning at the top level is highly complicated. One important duty of each government and of policy makers is planning at different levels for future problems. This research addresses such a concern. Planning for the future is the aim of this research. Moreover, the importance of the topic is discussed. The case study focused on is the nanotechnology industry and its development in Iran. Nanotechnology is one of the main and strategic industries in Iran. The important criteria for such a development are determined based on a literature review and the experiences from other countries. The different alternatives are selected based on the different applications of nanotechnology in other industries. The alternatives are: agriculture, transportation, construction, oil and gas, textile products, food industry, defence industry, health and medicine, nano electronics, nano energy and environment and water. The methodology employed is Multiple Criteria Decision Making (MCDM). In addition, SWARA-WASPAS is the hybrid MADM model employed in which SWARA is applied to evaluate the criteria and WASPAS is utilised to evaluate and rank the alternatives