Drug use in acute otitis media: a prospective study at a tertiary care teaching hospital

Background: Drug use study identifies the problems that arise from prescription and highlights the current approaches to the rational use of drugs. The objective of the study was to assess drug use pattern in patients diagnosed of acute otitis media in tertiary care teaching hospital.Methods: This prospective observational study was carried in the Otorhinolaryngology department of a tertiary care teaching hospital over a period of twelve months. The data collected for patients with acute otitis media included the patient's demographic details and the drugs prescribed. Data were analysed for drug use pattern and cost per prescription and assessment of rationality of prescription.Results: Total 153 patients were analysed, 100 (65.35%) belonged to male patients and 53 (34.65%) belonged to female patients. Children less than 2years age were the most diagnosed with AOM 47.71%, the major diagnostic symptoms were earache (58.16%) and fever (54.90%) and signs were congestion (52.94%) and discharge (43.13%). In a total 153 prescriptions (469 drugs), 33.68% were antimicrobials, followed by mineral supplements (23.67%). Average number of drugs per prescription was found to be 3.0. Most common antibiotic prescribed was amoxicillin (with or without clavulanate) in 142 (92.81%) patients. Paracetamol alone or in fixed dose combination with antihistaminics were prescribed in 131 patients. Average cost per prescription was 87.74(±35.67) Indian rupees. Seventeen (11.11%) prescriptions were rational in all the aspects based on standard guidelines.Conclusions: The present study showed that paracetamol and amoxicillin with or without clavulanate were mostly commonly prescribed in children with AOM. Irrational prescribing was seen in maximum number of cases

Prescription and cost-analysis of antiemetic medication use in pediatric wards: a prospective observational study

Background: Use of anti-emetic drugs in pediatric population is often warranted, but choice of drug remains questionable within pediatricians. Objective of current study is: to study prescribing pattern and to calculate cost of antiemetic drug therapy in pediatric wards.Methods: A prospective, observational study was conducted in pediatric wards of a tertiary care hospital of over 14 month’s duration. Institutional ethics committee approval was obtained and written informed consent of parents/guardians was taken. Data of any pediatric patient receiving anti-emetic agent were included in the study.Results: A total of 218 prescriptions were collected. Mean age of patients was 4.39±3.16 (range 4 months to 12 years). Gastroenteritis was the most frequently diagnosed disease in 137(63%) patients. Domperidone was prescribed in 52.4% and ondansetron in 47.6% children. Oral liquid dosage formulation was prescribed in 109 (48.4%) followed by solid dosage form 47 (20.9%). Mean cost of domperidone therapy was 25.34±6.55 INR and for ondansetron it was 36.62±17.94 INR.Conclusions: Gastroenteritis was most frequent indication for use of anti-emetics. Domperidone pharmacotherapy was cheaper and most frequently prescribed than ondansetron

Comparative Analysis of a Transition Region Bright Point with a Blinker and Coronal Bright Point Using Multiple EIS Emission Lines

Since their discovery twenty year ago, transition region bright points (TRBPs) have never been observed spectroscopically. Bright point properties have not been compared with similar transition region and coronal structures. In this work we have investigated three transient quiet Sun brightenings including a TRBP, a coronal BP (CBP) and a blinker. We use time-series observations of the extreme ultraviolet emission lines of a wide range of temperature T (log T = 5.3 - 6.4) from the EUV imaging spectrometer (EIS) onboard the Hinode satellite. We present the EIS temperature maps and Doppler maps, which are compared with magnetograms from the Michelson Doppler Imager (MDI) onboard the SOHO satellite. Doppler velocities of the TR BP and blinker are <,25 km s$^{-1}$, which is typical of transient TR phenomena. The Dopper velocities of the CBP were found to be < 20 km s^{-1} with exception of those measured at log T = 6.2 where a distinct bi-directional jet is observed. From an EM loci analysis we find evidence of single and double isothermal components in the TRBP and CBP, respectively. TRBP and CBP loci curves are characterized by broad distributions suggesting the existence of unresolved structure. By comparing and contrasting the physical characteristics of the events we find the BP phenomena are an indication of multi-scaled self similarity, given similarities in both their underlying magnetic field configuration and evolution in relation to EUV flux changes. In contrast, the blinker phenomena and the TRBP are sufficiently dissimilar in their observed properties as to constitute different event classes. Our work indicates that the measurement of similar characteristics across multiple event types holds class-predictive power, and is a significant step towards automated solar atmospheric multi-class classification of unresolved transient EUV sources.Comment: 38 pages, 16 figure

Sadašnjost i budućnost stentova za restenozu koji otpuštaju lijekove

Drug-eluting stents (DESs) prevail in the treatment of carotid artery diseases in the interventional cardiology world owing to their efficacy for significant reduction of restenosis. A current successful DES requires a polymer coating for drug delivery. Clinical trials examining several pharmaceutical agents have demonstrated marked reduction in restenosis following stenting. The development of DES is one of the major revolutions in the field of interventional cardiology. The ideal drug to prevent restenosis must have an anti-proliferative and anti-migratory effect on smooth muscle cells but, on the other hand, it must also enhance re-endothelialization in order to prevent late thrombosis. Additionally, it should effectively inhibit the anti-inflammatory response after balloon induced arterial injury. Although DES have significantly reduced the angiographic restenosis rate and have improved clinical outcomes, late thrombosis and restenosis remain an important subject of ongoing research.Stentovi koji otpuštaju lijekove (DESs) koriste se u kardiologiji za terapiju bolesti karotidnih arterija jer značajno smanjuju restenozu. Dobar DES ima polimerni sloj za isporuku lijekova. Klinički pokusi u kojima je ispitivano nekoliko agenasa pokazali su značajno smanjenje restenoze nakon ugradnje stenta. Razvoj DES-a jedno je od revolucionarnih otkrića u području interventne kardiologije. Idealni lijek za prevenciju restenoze mora imati antiproliferativni i antimigracijski učinak na stanice glatkih mišića, a s druge strane mora povećavati endotelizaciju kako bi se spriječila tromboza. Osim toga, treba učinkovito inhibirati protuupalni odgovor nakon ozljede arterije. Iako DES značajno smanjuje restenozu krvnih žila, kasna tromboza i restenoza ostaju i dalje problem i predmet brojnih istraživanja

A phase 1 study evaluating rovalpituzumab tesirine in frontline treatment of patients with extensive-stage SCLC

INTRODUCTION: Rovalpituzumab tesirine (Rova-T) is an antibody-drug conjugate targeting DLL3, a Notch pathway ligand highly expressed on SCLC cells. Rova-T was evaluated alone or in combination with platinum-based chemotherapy (cisplatin or carboplatin combined with etoposide [CE]) in frontline treatment of extensive-stage SCLC. METHODS: One cycle of CE pre-enrollment was permitted (later mandated). The following four cohorts were enrolled: Rova-T monotherapy (0.3 mg/kg, every 6 [q6] wk × 2; cohort 1; n = 4); Rova-T induction (0.3 mg/kg, q6 wk × 2) followed by CE every 21 days (q21) × 4 (cohort 2; n = 5); Rova-T (0.1 or 0.2 mg/kg, q6 wk × 2) overlapping with CE q21 × 4 (cohort 3; n = 14); and Rova-T maintenance (0.3 mg/kg, q6 wk × 2) after CE q21 × 4 (cohort 4; n = 3). RESULTS: A total of 26 patients were dosed (cohort 3: 14; cohorts 1, 2, and 4 combined: 12). Median age was 66 years, and 73% had Eastern Cooperative Oncology Group performance status of 1. In cohort 3, seven patients (50%) had confirmed objective responses, with a median progression-free survival of 5.2 months and median overall survival of 10.3 months. Compared with cohorts 1, 2, and 4 combined, cohort 3 had lower frequency of some Rova-T-related adverse events of special interest, such as pleural effusion (0 versus 33%), pericardial effusion (0 versus 17%), ascites (0 versus 8%), peripheral edema (36% versus 42%), generalized edema (0 versus 8%), pneumonia (7% versus 25%), and hypoalbuminemia (0 versus 17%). CONCLUSIONS: Lower Rova-T doses may be associated with lower incidence of some Rova-T-related adverse events of special interest. Rova-T 0.2 mg/kg plus CE (cohort 3) was tolerable; however, there was no clear efficacy benefit of adding Rova-T to CE

Convergent Evolution of Escape from Hepaciviral Antagonism in Primates

Escape from antagonism by hepatitis C and related viruses has repeatedly evolved in antiviral factor MAVS via convergent evolution, revealing an ancient history of previous viral encounters in primates