Comparison of efficacy of methylprednisolone with dexamethasone in moderate to severe COVD-19 patients in a tertiary care hospital

Background: The aim was to compare efficacy of methylprednisolone with dexamethasone in moderate to severe COVID-19 patients in a tertiary care hospital. Method: A retrospective observational study was conducted by collecting data of moderate to severe COVID-19 patients admitted to covid wards of a tertiary care hospital for a period of six months. Demographic data, information about SpO2 changes, duration of hospitalization, marker status and ventilation status were parameters collected and used to compare between two groups. Results: Total number of patients in this study were 130. Out of which 65 patients who were on Methylprednisolone belonged to group A and 65 patients taking dexamethasone belonged to group B. In group A 56 (86.2%) were males and 9 (13.8%) were females. In group B 51 (78.5%) were males and 14 (21.5%) were females. Mean age in group A was 54.75±14.96 (age range b/w 25-80 years) and in group B was 55.43±15.83 (age range between 23-84 years). Patients in group A showed more presence of comorbidity (44.6%) as compared to group B (32.3%). Mean SpO2 level on day 1 in group A was 86.37±7.58 and in group B was 88.11±4.38. On day of discharge mean SpO2 level was 95.05±1.54 in group A and 94.63±2.09 in group B. Mean length of hospital stay in group A was 9.78±7.38 and in group B was 7.88±4.76. Improvement in marker status for group A was 100% and for group B 95.4%. Ventilation status in both groups showed 100% improvement. Conclusions: Both steroids are effective in management of moderate to severe COVID-19 patients

Drug utilization study of antipsychotics among schizophrenia patients in a tertiary care teaching hospital: a retrospective observational study

Background: Aim of the study was to evaluate the drug utilization pattern of antipsychotics in schizophrenia patients in a tertiary care hospital.Methods: A retrospective observational study was conducted over a period of one year. Demographic data and drug utilization pattern of antipsychotics was collected from the surveyed prescriptions. Using WHO prescribing indicators data was analysed. Results were expressed in percentage.Results: Out of 300 prescriptions analysed, males were 58% and females 42%. Majority of schizophrenia patients were in age group of 15 to 45 years 70.33%. Olanzapine 75% was most common antipsychotic drug prescribed followed by risperidone 10.7%. Haloperidol 9.6%, fluphenazine 3.7% and chlorpromazine 1% were the other antipsychotics prescribed. Atypical antipsychotics 85.7% were commonly prescribed than conventional ones 4.3%. Concomitant drugs prescribed were anticholinergics, antihistaminics, sedative-hypnotics, antidepressants, mood stabilizers, antiulcer drugs and vitamin B complexes. Average number of drugs prescribed per prescription 3.26.Conclusions: Nowadays atypical antipsychotics are preferred over conventional ones because of their less side effects. Drug utilization study helps in rational usage of drugs important for patient care

How is Death Hastening Done? A Review of Existing Sanctioned Death Hastening Decision-Making Processes and Practices

Death hastening is a controversial terminal care option that is currently carried out in only four countries and some US states, with Canada posed to allow it on June 6, 2016. This article focuses on how assisted suicide and euthanasia have been managed in the four countries and US states where it has been sanctioned and practiced. A systematic literature review and additional searches were employed to gain information on the methods, recipients, procedures, regulations, outcomes, and other information available on state-sanctioned death hastening. The findings reveal many different possible models and thus considerations required for planning in advance of death hastening actually occurring.  &nbsp

Critical properties of the double exchange ferromagnet Nd0.4Pb0.4MnO3

Results of a study of dc-magnetization M(T, H), performed on a Nd0.6Pb0.4MnO3 single crystal in the temperature range around T_C (Curie temperature) which embraces the critical region | epsilon | = |T -T_C |/T_C <= 0.05 are reported. The magnetic data analyzed in the critical region using the Kouvel-Fisher method give the values for the T_C =156.47 +/- 0.06 K and the critical exponents, beta = 0.374 +/- 0.006 (from the temperature dependence of magnetization), and gamma = 1.329 +/- 0.003 (from the temperature dependence of initial susceptibility). The critical isotherm M(T_C, H) gives delta = 4.547 +/- 0.1. Thus the scaling law gamma+beta=delta beta is fulfilled. The critical exponents obey the single scaling-equation of state M(H, epsilon) = epsilon^b f_+/- (H/epsilon^(beta + gamma)) where, f_+ for T > T_C and f_- for T< T_C. The exponent values are very close to those expected for the universality class of 3D Heisenberg ferromagnets with short-range interactions.Comment: 19 pages, including 6 figure

Drug utilization study and adverse drug reactions of oral anti diabetics among type 2 diabetes mellitus patients in tertiary care hospital

Background: The aim was to evaluate the drug utilization pattern of oral antidiabetic drugs in type 2 diabetes mellitus outpatients and monitor adverse drug reactions (ADRs) associated with oral antidiabetic drugs.Methods: A retrospective observational study was carried out by collecting the data of type 2 diabetes mellitus patients visiting outpatient department of noncommunicable disease clinic of a tertiary care hospital for a period of one year. The data of demographic, drug utilization pattern and adverse drug reactions of patients on oral antidiabetic drugs was collected and entered in a proforma.Results: Total number of patients in this study were 39 out of which 21 (53.85%) patients were females and 18 (46.15%) patients were males. Majority of patients were in the age group 51-70 years (66.6%). Metformin was the most commonly prescribed drug 76.9% followed by Glibenclamide 17.9%. About 7.7% of patients who were taking oral antidiabetic drugs later switched over to insulin as their blood glucose levels were not controlled. Out of 18 (46.15%) patients, hypertension (38.5%) was the most common comorbid condition and a concomitant drug was prescribed was amlodipine 25.6%. Among all the adverse drug reactions observed, diarrhoea was the most common adverse drug reaction reported 76.9%.Conclusions: Metformin was the most commonly used oral antidiabetic drug. Diarrhoea was the common adverse drug reaction reported

Study of adverse drug reactions among tuberculosis patients in a tertiary care hospital: a retrospective observational study

Background: The aims of the study was to study adverse drug reactions (ADRs) among tuberculosis (TB) patients in a tertiary care hospital and to determine causality, severity and outcome of ADRs.Methods: A retrospective observational study was conducted in a tertiary care hospital over a period of 6 months. Data was collected from records of TB patients in RNTCP centre of a tertiary care hospital regarding information of patients, drugs used, ADRs. It was evaluated using appropriate scales. Simple descriptive statistics was used for analysis.Results: Out of 37 patients who experienced ADRs, 22 (59.45%) were male and 15 (40.54%) were female. Majority of patients were in the age group of 36 to 45 years (37.83%). 36 (97.3%) patients were diagnosed with pulmonary TB and 1 (2.7%) patient had extra pulmonary TB. Among 37 ADRs gastrointestinal (GI) reactions were most common 11 (29.72%) followed by musculoskeletal 9 (24.32%). Causality assessment showed 19 (51.35%) as probable and 18 (48.65%) ADRs as possible, Severity assessment was 24 (64.8%) reactions were in mild, 10 (27.02%) in moderate and 3 (8.1%) in severe grades. Outcome assessment was 26 (70.3%) patients were recovering from reactions, 9 (24.32%) had recovered and 2 (5.4%) did not recover at the time of reporting.Conclusions: Proper monitoring of ADRs helps in reducing patient’s burden of repeated hospital visits and expense occurring due to admissions. This can be prevented by educating patients about early reporting of ADRs