Pattern of medication use among elderly patients attending medicine department in a tertiary care hospital in India

Objective: The present study was aimed to assess the drug prescribing pattern and analyze the prescribing pattern using Beers criteria among elderly patients aged over 60 years Materials and Methods: The present study was a prospective observational study conducted in the outpatient department of general medicine in a tertiary care hospital for the duration of three months. Institutional ethics committee approval was taken prior to initiation of the study. Written informed consent was taken from each study subject. A total of 287 subjects who were aged more than 60 years recruited into the study. The data was collected in a pre structured case record form. Subjects' demographic details, medical conditions and drugs included in prescription their dose; frequency and duration were noted in case record form. Results: Among 287 subjects 91.64% subjects belonged to 61-70years age group, remaining 8.36% subjects were >71year older and 57.14% were males and 42.86% were females. Hypertension was the most common cause of attending hospital followed by diabetes mellitus, CNS disorders, respiratory, cardiovascular disorders other than hypertension and infectious diseases. A total of 1574 formulations containing 1669 active ingredients and 90 FDCs were prescribed. And only 152 formulations were prescribed from outside hospital formulary. The average number of drugs per prescription was 5.48±2.00. Among the individual drugs vitamin B complex was the most commonly prescribed drug Conclusion:  There is need for more rational prescribing and to form guidelines for safe and effective use of medicines in elderly patients

Design and Analysis of Distributed Faulty Node Detection in Networks

Propagation of faulty data is a critical issue. In case of Delay Tolerant Networks (DTN) in particular, the rare meeting events require that nodes are efficient in propagating only correct information. For that purpose, mechanisms to rapidly identify possible faulty nodes should be developed. Distributed faulty node detection has been addressed in the literature in the context of sensor and vehicular networks, but already proposed solutions suffer from long delays in identifying and isolating nodes producing faulty data. This is unsuitable to DTNs where nodes meet only rarely. This paper proposes a fully distributed and easily implementable approach to allow each DTN node to rapidly identify whether its sensors are producing faulty data. The dynamical behavior of the proposed algorithm is approximated by some continuous-time state equations, whose equilibrium is characterized. The presence of misbehaving nodes, trying to perturb the faulty node detection process, is also taken into account. Detection and false alarm rates are estimated by comparing both theoretical and simulation results. Numerical results assess the effectiveness of the proposed solution and can be used to give guidelines for the algorithm design. PRD assigns weights to individual links as well as end-to-end delay, so as to reflect the node status in the long run of the network. Large-scale simulation results demonstrate that PRD performs better than the widely used ETX metric as well as other two metrics devised recently in terms of energy consumption and end-to-end delay, while guaranteeing packet delivery ratio.

Resonance energy transfer from a fluorescent dye molecule to plasmon and electron-hole excitations of a metal nanoparticle

We study the distance dependence of the rate of electronic excitation energy transfer from a dye molecule to a metal nanoparticle. Using the spherical jellium model, we evaluate the rates corresponding to the excitation of l = 1, 2, and 3 modes of the nanoparticle. Our calculation takes into account both the electron-hole pair and the plasmon excitations of the nanoparticle. The rate follows conventional R^-6 dependence at large distances while small deviations from this behavior are observed at shorter distances. Within the framework of the jellium model, it is not possible to attribute the experimentally observed d^-4 dependence of the rate to energy transfer to plasmons or e-h pair excitations.Comment: 4 figure

Drug utilization study of anti-hypertensive drugs in a tertiary care hospital

Background: Hypertension is a major non-communicable disease and a risk factor for cardiovascular diseases. The antihypertensive drugs used for its management constitute a significant portion of the medicines prescribed in a health care centre. The aim of our study was to analyse the utilization pattern of anti-hypertensive drugs at a tertiary care hospital in accordance with the WHO prescription indicators.Methods: A prospective cross sectional observational study was carried out in the outpatient of general medicine department of Osmania General Hospital. The prescriptions of the hypertensive patients visiting the outpatient were monitored. From the data collected, the prescription pattern of antihypertensive drugs, and WHO prescription indicators, were analysed.Results: Out of the 301study subjects, 134 (44.51%) were males and 167 (55.48%) were females, with the maximum number of patients (197) falling in the age group 51-70 years. Among the antihypertensive drugs prescribed, Amlodipine was most frequently prescribed (53.15%). The frequently used drugs for monotherapy - amlodipine (26.91%) and for two drug therapy - amlodipine+enalapril (17.27%), and for three drug therapy - atenolol+enalapril+nifedipine (2.32%). The WHO prescribing indicators as analyzed from the data collected are; Average number of drugs prescribed per encounter - 5.64/prescription, Percentage of medicines prescribed by generic name - 89.22%, Percentage of medicines prescribed from essential drug list -90.17% .Conclusions: The study provides an insight into antihypertensive drug usage pattern in tertiary care hospital and their rational use. The study emphasizes the need for preventive measures and effective educative measures in the population about hypertension

Adverse drug reaction profiles of commonly used platinum compounds in cancer chemotherapy

Background: The aim of the present study was to monitor and analyze the pattern of occurrence of adverse drug reactions (ADRs) to commonly used platinum compounds in MNJ Cancer Hospital, Hyderabad.Methods: Cancer patients, who received platinum compounds as chemotherapy regimen, were monitored for adverse reactions. Cancer patients belonging to either gender and of all ages, who were receiving platinum compounds under any standard regimen, were included for the study. Cases that were unlikely, conditional or unaccessible under World Health Organization (WHO)-Uppsala Monitoring Centre causality criteria were excluded from the study. The ADRs were recorded in Central Drugs Standard Control Organization forms. Causality was assessed by the WHO Causality Assessment Scale and Naranjo’s Algorithm. Preventability and severity of ADRs were assessed by modified Schumock and Thornton scale, modified Hartwig and Siegel scale, respectively.Results: Among 100 patients, 78 developed ADRs to platinum compounds. The reactions observed were vomiting, diarrhea, abnormal renal function tests, myelosuppression, anemia, thrombocytopenia, alopecia, and constipation. The WHO Causality Assessment Scale indicated 64.6% “possible” and 35.4% “probably,” but no “certain” reactions. Naranjo’s Algorithm showed 59.4% “possible” 40.6% “probable” reactions. 48% reactions were “definitely preventable” 16% were “probably preventable” and 36% were “not preventable.” Modified Hartwig and Siegel Scale of severity assessment showed that 12% reactions were “mild” 69% were “moderate” and 19% were severe.Conclusion: Platinum compounds have high potential for adverse effects. There is a need to improve the management of adverse effects. This study also emphasizes the need to improve pharmacovigilance awareness among physicians in order to improve the pharmacovigilance in India

Indigenous Tools Used in Sugarcane Farming Systems in South India

Indigenous tools have been in vogue from time immemorial. Indian agriculture has a rich repertoire of indigenous tools designed for different types of crops, each unique in design and functional qualities to aid the farmers in crop cultivation

A PROSPECTIVE INTERVENTIONAL STUDY OF KNOWLEDGE, ATTITUDE AND PRACTICE (KAP) TOWARDS TUBERCULOSIS AMONG PATIENTS WITH KOCH'S DISEASE

ABSTRACTObjective: To evaluate the knowledge, attitude and practice (KAP) of tuberculosis patients and to provide structured patient education through patient counselling on disease, drugs and lifestyle modifications in tuberculosis patients.Methods: All enrolled patient received structured & standard education regarding the disease tuberculosis, medication, diet & lifestyle modification after the preliminary assessment of KAP towards TB. Changes in the knowledge, attitude, and practice in the post-intervention phase were assessed and analyzed statistically.Results: Change in knowledge score of the patients before and after counselling was observed as 37.74% to 79.06% where the mean change in percentage is 41.32%. The change in the attitude of the patients before and after counselling was found to be 21.61%. Counseling towards practice before and after counseling was increased from 63.18% to 82.12% with a mean change of 18.94%.Conclusion: Change in KAP due to educating the patients would help in the increased adherence to antitubercular therapy (ATT) in the patients with tuberculosis; thereby resistance towards the drugs can be reduced.Keywords: Tuberculosis, Koch's disease, Compliance, KAP study

A CONCEPTUAL STUDY ON PANCHAKARMA APPROACH IN THE MANAGEMENT OF ANKYLOSING SPONDYLITIS

Ankylosing spondylitis is characterized by a chronic inflammatory arthritis predominantly affecting the sacro-iliac joints and spine, which can progress to bony fusion of the spine. The onset is typically between the ages of 20-30, with male preponderance of about 3:1. The main symptoms like musculoskeletal pain, stiffness and decreased range of movements in the spine. Modern science has very limited options to treat Ankylosing spondylitis. So, the necessity of management through Ayurveda is very much essential. Various disease entities like Amavata, Gambhira Vatarakta, Asthimajjagata vata can be considered under the spectrum of Ankylosing Spondylitis. By understanding the symptoms of Ankylosing Spondylitis, the pathology pertaining to the Ankylosing Spondylitis can be considered under the Sama and Nirama avastha. A thorough differentiation of Sama and Nirama avastha of Ankylosing spondylitis (Gambhira Vatarakta) has to be done based on the same, Panchakarma procedures are to be adopted. Among various modalities of treatments, Panchakarma can be the better option to treat this condition. Hence, a conceptual study was taken up to develop an approach through Panchakarma modalities in the management of Ankylosing Spondylitis