An observational study to assess the drug prescription pattern and quality of life of acne vulgaris patients in a tertiary care center in India

Background: The study was conducted to assess the prescription pattern of acne vulgaris patients, and impact of anti-acne treatment on severity of acne and change in quality of life (QoL) in patients.Methods: A prospective observational study was conducted in dermatology OPD of a tertiary care hospital with 160 patients of acne vulgaris. All patients with acne vulgaris >18 years, of either sex were included while those with pre-existing other cutaneous or systemic diseases, pregnant and lactating females and not giving consent were excluded from the study. Prescriptions were analysed and patients were followed-up at 2 and 6 weeks for assessment of change in acne severity and QoL, determined by GAGS score and CADI difference score, respectively.Results: Mean age of patients was 20.7±2.5 years, with males and females constituting 62 (38.8%) and 98 (61.3%) patients, respectively. Acne was mild in 88 (55%), moderate in 51 (31.9%) and severe in 21 (13.1%) patients. A total of 537 drugs were prescribed to all patients, with an average of 3.36 drugs per prescription. Two, 3 and 4 drugs were prescribed in 2.5%, 59.4% and 38.1% patients, respectively. There was significant improvement in the GAGS score (p<0.001) and QoL (CADI score difference) (p<0.001) at 2 and 6 weeks follow-up compared to initial visit.Conclusions:Polypharmacy was a common practice in anti-acne treatment. However, it was associated with improvement in acne severity and QoL.

Drug utilization study in ophthalmology in OPD patients at a tertiary care teaching hospital

Background: Drug therapy is a major component of patient care management in health care settings. Irrational and inappropriate use of drugs in health care system observed globally is being a major concern. In the field of ophthalmology, there have been many drug developments and different classes of drugs with combinational products are available in ophthalmology for the treatment of ophthalmic diseases. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objectives were to study the prescribing pattern and drug utilization trends in Ophthalmology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of six months in Ophthalmology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 103 adult patients visiting Ophthalmology OPD for curative symptoms were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 1.9. Percentage of drugs prescribed by brand was 100 % versus generic 0 %. Percentage of drugs prescribed from National Essential drug list (NEDL) was 53%. The percentage of encounters with antibiotics was 30.6%. The commonest prescribed drugs were ocular lubricants followed by antibiotics. Eye drops were the commonest prescribed dosage form.Conclusions: Ocular lubricants and antibiotics dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologist to prescribe generic and selection of essential drugs

The fate of the distal aorta after repair of acute type A aortic dissection

ObjectivesThe residual aorta’s behavior after repair of acute type A dissection is incompletely understood. We analyzed segmental growth rates, distal reoperation, and factors influencing long-term survival.MethodsOne hundred seventy-nine consecutive patients (70% male; mean age, 60 years) with acute type A dissection underwent aggressive resection of the intimal tear and open distal anastomosis (1986-2003). Hospital mortality was 13.4%. Survivors had serial computed tomographic scans: digitization yielded distal segmental dimensions. Segment-specific average rates of enlargement and factors influencing faster growth were analyzed. Distal reoperations and patient survival were examined.ResultsEighty-nine (57%) patients had imaging data sufficient for growth rate calculations. The median diameters after repair were as follows: aortic arch, 3.6 cm; descending aorta, 3.7 cm; and abdominal aorta, 3.2 cm. Subsequent growth rates were 0.8, 1.0, and 0.8 mm/y, respectively. Initial size of greater than 4 cm (P = .005) and initial diameter of less than 4 cm with a patent false lumen (P = .004) predicted greater growth in the descending aorta, and male sex (P = .05) significantly affected growth in the abdominal aorta. No significant factors were found for the aortic arch. There were 25 distal aortic reoperations (16 patients), and risk of reoperation was 16% at 10 years. Risk factors reducing long-term survival after repair of acute type A dissection included age (P < .0001), new neurological deficit at presentation (P = .04), absence of preoperative thrombus in the false lumen of the ascending aorta (P = .03), and a patent distal false lumen postoperatively (P = .06) but not distal reoperation.ConclusionsGrowth of the distal aorta after repair of acute type A dissection is typically slow and linear. Distal reoperation is uncommon, and late risk of death is approximately twice that of a healthy population

Drug utilization study in ophthalmology in OPD patients at a tertiary care teaching hospital

Background: Drug therapy is a major component of patient care management in health care settings. Irrational and inappropriate use of drugs in health care system observed globally is being a major concern. In the field of ophthalmology, there have been many drug developments and different classes of drugs with combinational products are available in ophthalmology for the treatment of ophthalmic diseases. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objectives were to study the prescribing pattern and drug utilization trends in Ophthalmology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of six months in Ophthalmology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 103 adult patients visiting Ophthalmology OPD for curative symptoms were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 1.9. Percentage of drugs prescribed by brand was 100 % versus generic 0 %. Percentage of drugs prescribed from National Essential drug list (NEDL) was 53%. The percentage of encounters with antibiotics was 30.6%. The commonest prescribed drugs were ocular lubricants followed by antibiotics. Eye drops were the commonest prescribed dosage form.Conclusions: Ocular lubricants and antibiotics dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologist to prescribe generic and selection of essential drugs

Intimate Subjects and Virtual Spaces: Rethinking Sexuality as a Category for Intimate Ethnographies

This paper was accepted for publication in the journal Sexualities and the definitive published version is available at https://doi.org/10.1177/1363460716677285.Social networking sites and digital technologies have created opportunities for young people in India to establish virtual intimate connections. In this article we analyse the intimate exchanges between young men on two different digital platforms - Facebook and Planet Romeo. An analysis of the intimate virtual exchanges reveals technologies of queer neoliberal subject formation within contemporary India. Queer neoliberal subject formation refers to the emergence of a sexual subject of rights, one that is a consumer-citizen within the Indian free-market economy. The article highlights two kinds of ways in which bodies are being queered within present day India. First, we discuss the case of run-away young men, whose bodies are marked as failure, a kind of ‘delinquent’ subject by an ensemble of state and civil-society formations. The young men are escaping violence from male elders, and poor living conditions in peri-urban Kolkata. Their bodies come to signify a queer figure within neoliberal notions of success and enterprise. Secondly, we interrogate the ways in which homosexuality is an emergent juridico-political category in India. The Supreme Court of India ruling on 11th December 2013, which reinstated the anti-sodomy provisions of the Indian Penal Code (IPC 377), is the site for the sedimentation of ‘homosexual’ as a subject of legal rights. The homosexual is being presented as a subject of conjugal love. Conjugality is represented as a private good, as the right to consume intimacy within private space. Representation of intimacy and celebration of conjugal love is found through the growth of dating websites in India along with the proliferation of media texts such as memes, poems and illustrative images found online commemorating conjugality. Our ethnographic analysis of the virtual exchanges among runaway young men, and young gay identified men reveal how neoliberal subject formation in India remains incomplete