Drug utilization study in patients with type 2 diabetes mellitus attending diabetes clinic of a tertiary care hospital in rural Bengal

Background: Diabetes mellitus (DM) is a common and important health problem affecting the citizens of developed as well as developing nations. Not only does it require long term therapy, it is also crippling in terms of cost of management. Drug utilization studies help to determine rational drug use especially in poorer and rural populations. The objective of this study was to evaluate drug utilization pattern in type-2 diabetes patients in a diabetic clinic of a tertiary care teaching hospital in rural Bengal.Methods: This was a prospective observational study including 181 patients for a period of 6 months in Bankura Sammilani Medical College. Patients diagnosed as type 2 diabetes mellitus were included in the study. The demographic data, disease data and utilization of different classes of oral hypoglycaemic agents and insulin as well as other individual drugs were analysed using the World Health Organization (WHO) indicators for drug utilization studies.Results: The study population was predominantly male (61.33%) and nearly a third (30.9%) belonged to the age group of 50-59 years. Co-morbid conditions were found in 74% patients, among which hypertension (51.1%) was the most common co-morbid condition. The average number of drugs per prescription was 4.22 and the average number of antidiabetic drugs per prescription was 2.18. Metformin was the most commonly prescribed drug (79.6%), followed by sulfonylurea class of drugs (66.9%). Nearly 17.7% patients were on insulin preparations. Glimepiride and metformin was the most common combinations used (45.5%). Antibiotics were included in 15.5% prescriptions and proton pump inhibitors were prescribed in 32% cases. All the medicines were prescribed as generics and injections were prescribed in 17.7% cases.Conclusions: This study gives a picture of the pattern of drug use among diabetes patients in our set up. While metformin was the commonest drug used, glimepiride and metformin combination was the commonest combination therapy

MIXED MODE PERFORMANCE OF GAAS UTB-MOSFET WITH EXTRA INSULATOR REGION AND UNDOPED BURIED OXIDE REGION

Investigation of mixed mode performances for GaAs UTB-MOSFET at nanoscale regime keeping in view of “Beyond CMOS” is the current trend of semiconductor industry. Here it is proposed to modify conventional models by considering an extra Insulator Region (IR) and Undoped Buried oxide Region (UBR) to study the performance related to digital and analog/RF applications. Here a GaAs is considered as the channel material. The IR-UTB-SOI-n-MOSFET has shown promising results with respect to SS, DIBL, fT and switching speed

Teachers’ professional learning during and after Covid: A role for open digital badges

This report examines how open digital badges could support successful Teacher Professional Development (TPD) at scale. We present insight from two one-day events attended by practitioners and senior educational leaders in India and two pilot interventions that integrated digital badges into courses developed in response to the Covid-19 pandemic. TPD gives teachers the opportunity to improve, adapt and innovate their classroom practice and never has it been more critical than in helping shape the educational and societal response to recent global disruptions. In many countries, such as India where our study is based, digital badges are little used in TPD, so this study makes an important contribution to understanding the perception and value attached to digital badges and in supporting discussions that frame emerging narratives and practice. A knowledge exchange partnership of academics from The Open University, UK (OU) and Tata Institute of Social Sciences, India (TISS) supported by GCRF funding has been instrumental in delivering the activities and findings discussed

An ANN Based Call Handoff Management Scheme for Mobile Cellular Network

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The Effect of dexamethasone on fetal heart rate variability, by non-invasive non-stress test tracing in preterm labour

Background: To analyse the effects of antenatal dexamethasone on fetal heart rate variability (fHRV), when administered to mothers between 30-37 weeks of gestation, at risk of preterm delivery and corroborate presenting maternal symptoms with mode of delivery and perinatal outcomes. Method: Prospective observational study conducted for 1 Year among pregnant women with gestation between 30 completed weeks to 36 weeks 6 days, with symptoms suggesting risk of preterm delivery. The sample size calculated was 52. Dexamethasone phosphate, 24 mg in 4 divided doses, was administered as intramuscular injections 12 hours apart. NST tracings were taken at three points-before first dose, one hour after first dose and one hour after the fourth dose. Chi-square test and Paired t test was applied, p<0.05 was considered statistically significant.  Results: Strong correlation was found between antenatal dexamethasone administration and fHRV (p<0.05) which increased after administration of the first dose of dexamethasone compared to its value prior to administration. There was a further increase after the fourth dose.  Conclusions: Dexamethasone is associated with increase in fHRV evident on non-stress test recordings, without significant decrease in baseline fetal heart rate

An observational study of abdominal organ involvement detected by ultrasound and computed tomography in children suffering from lymphoreticular malignancy at a tertiary care hospital in Eastern India

Introduction: Abdominal organs are usually involved in lymphoreticular malignancies (LRM), and the detection is crucial for Initial staging, determination of the location and extent of disease, and is the hallmark for the choice of treatment. At present, the established radiological technique for staging Hodgkin's disease is computed tomography (CT) and ultrasonography (USG) in our country. Objective: The objective of the study was to evaluate the pattern of abdominal organ involvement in childhood LRM by USG and CT and to analyze the findings. Methods: The study included 121 children with newly diagnosed childhood LRM who underwent real time USG and contrast enhanced CT scan. The records of the US and CT scanning were analyzed with respect to size, shape, margins, echogenicity/density pattern of various abdominal organs and lymph nodes to evaluate the extent and pattern of abdominal organ involvement by the disease process. Results: Out of 121 cases of LRM, US detected significant portal lymphadenopathy in 9 (7.44%) cases where CT detected enlarged portal nodes in only 3 and missed in 6 cases. However in the retroperitoneal lynphadenopathy CT scored over US, as CT detected 16 (13.22%) cases as against 13 (10.74%) cases detected by US. Conclusion: In our study we observed abdominal organs are commonly involved at the time of initial presentation in childhood LRM, with diffuse organomegaly being commoner than focal lesions. Abdominal symptoms and GIT involvement were also found more common in NHL patients at their initial presentation. There are no characteristic patterns of involvement either on US or CT which are specific to any individual disease entity. Although organomegaly and focal lesions are not diagnostic, but in a known case of childhood LRM these are highly suggestive of involvement by the existing disease process. There is no significant difference in the detection rate of abdominal organ involvement by US and CT in our study. However US being safer and cheaper, US may be suggested as the primary imaging modality to detect abdominal organ involvement in childhood LRM at initial presentation