An audit of iron therapy in patients with iron deficiency anemia in a tertiary care hospital

Background: Iron deficiency anemia (IDA) is a major nutritional problem globally, which is especially true in the developing countries like India. Even though the treatment is simple and effective, there is a high prevalence of IDA. The reason for this is partly due to non-compliance of the patients and partly due to ineffective or incomplete treatment by the physicians. Hence, the present study was done with the objective to study the treatment pattern in patients with IDA.Methods: This retrospective observational study was conducted in the Medical Records Department, Pondicherry Institute of Medical Sciences (PIMS), Puducherry for a period of 1-year with a sample size of 100 patients. Patients of all ages and either sex diagnosed to have mild to severe IDA were included in the study. The following data like: demographic details, hemoglobin, drugs used to treat the anemia, duration of treatment were obtained. The data will be presented as descriptive statistics.Results: Out of the 100 patients scrutinized 57% had severe IDA, 39% moderate IDA, and 4% had mild IDA. Of the 100 patients, 71% were females and 29% were males. For 14% of the patients, no treatment was given and for 19% of the patients treatment was given but the duration of treatment was not mentioned.Conclusions: The results of the present study showed that majority of the patients with IDA did not receive the recommended WHO treatment. The present study shows that even though the treatment of a common nutritional disorder-IDA is simple and effective, the prevalence of the same is high, and the majority of the patients are being undertreated. Patients should also be educated about the implications of the disorder and the importance of its treatment

Cheap Retrieval Bag for Laparoscopic Cholecystectomy

Gallstone disease is one of the most common gastrointestinal conditions that require surgery and currently laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic cholelithiasis. Use of a laparoscopic bag for facilitating extraction/ morcellation of the operative specimen has been shown to minimize infection of wound and abdominal cavity. Various laparoscopic bag substitutes like latex gloves and glove fingers have been used. We described a sterilized plastic surgical drain cover as a reasonable substitute for retrieving the gallbladder after LC

PRESCRIPTION ERRORS IN THE DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY: A CROSS-SECTIONAL, OBSERVATIONAL STUDY

ABSTRACTObjective:  Prescription writing is an art. Writing a correct prescription in compliance with the WHO guidelines requires regular practice. Mistakesin prescription writing are inevitable. Hence, this study was done to analyze the prescriptions from the Outpatient Department of Obstetrics andGynaecology for errors. To analyze the prevalence and types of common prescribing errors in the Outpatient Department of Obstetrics and Gynaecology.Methods:  This cross-sectional study was conducted in the Department of Pharmacy, Pondicherry Institute of Medical Sciences, Puducherry. 500prescriptions from the Obstetrics and Gynaecology Outpatient Department were collected and analyzed. The study duration was 6 months (JulyDecember2014). The prescriptionswereanalyzedforerrors.Results: Our study revealed that 30.8% of the prescriptions had, at least, one error in them. The majority of the prescriptions had the doctors' signand patient details written in them. The dose of the drug was missing in about 38% of the prescriptions. None of the prescriptions had Type A errorin our study.Conclusion: It was found that prescription errors are still prevalent. The prescribers' have to be updated about the prescribing guidelines and regularauditing should be done to avoid these errors.Keywords: Prescription errors, Obstetrics and gynaecology, Classification of errors

Prevalence of potentially inappropriate medication use and drug utilization pattern in elderly patients: a prospective study from a tertiary care hospital

Background: To investigate the prevalence of potentially inappropriate medications (PIMs) using updated Beers criteria 2012 and drug utilization study among the elderly patients attending the various outpatient departments (OPDs) of a tertiary care hospital at Pondicherry in India.Methods: This prospective, observational study involving patients aged 65 years and above, was planned and conducted over a period of six months, who attended the various OPDs were included in the study. Prescriptions were collected from the consulting rooms and pharmacy.Results: A total of 600 patients aged 65 years and above were involved in our study. Majority (61.83%) were in the age group of 65-70 years. There was a male preponderance (61.83%). Total of 1769 drugs were prescribed, giving an average of 2.98 drugs per person (range 1 to 9). Polypharmacy (≥ 5drugs) were observed in 99 patients. Of the total 748 disease conditions, cardiovascular diseases were the most prevalent (29.33%) among the elderly patients. Almost 114 patients had comorbid conditions. General medicine department was the highest (28.83%) visited patients. Frequently prescribed drugs belong to the category of analgesic and anti-inflammatory agents (16.50%). Fixed Dose Combination (FDC) was 31%. Almost 110 patients received PIMs from Beers list; majority were belonging to category 1. NSAIDs (30.66%) were the highest PIMs prescribed to musculoskeletal disorders. With regard to WHO indicator, 377(21.31%) drugs were prescribed by generic name. Utilization from Indian national list of essential medicine was 76.82%. Percentage of encounters in which an antibiotic and injections was prescribed to 23.5% and 26.33% respectively.Conclusions: Study has shown the prevalence of disease pattern, comorbidity, drug usage in elderly. PIMs, polypharmacy and FDC were high among the elderly. Prescribers need to be educated about Beers criteria and encouraged for rational prescription.

Mixed Mucinous Carcinoma of the Male Breast

Male breast malignancy is extremely rare, representing less than 1% of all breast carcinomas. Infiltrating duct carcinoma is the commonest subtype. Pure mucinous carcinoma and mixed mucinous carcinoma wherein there are components of both mucinous carcinoma and infiltrating duct carcinoma are rare tumours constituting 1.5-5% in women and are even rarer in men. We present here a case of mixed mucinous carcinoma of the breast with metastasis to axillary lymph nodes in a male patient

Prescription pattern of fixed dose drug combinations in obstetrics and gynecology department of a tertiary care hospital in Puducherry, India: an observational study

Background: Fixed drug combinations (FDCs)have various advantages and disadvantages. In countries like India there are numerous irrational prescriptions as highlighted by the recent banning of FDCs in October 2018. Studying the prescription pattern helps in developing national database which can be used to promote rational use of drugs.Methods: All the Outdoor Patient Department (OPD) prescriptions from department of Obstetrics and Gynecology (OBG) during the study period were used for the study. The drugs were classified according to Anatomical Therapeutic Chemical (ATC) classification. Other data studied were the number of FDCs and the number of currently banned combinations which were used during the study period.Results: The 41% of the drugs prescribed as FDCs. Most FDCs belonged to alimentary system followed by anti-infectives and blood and blood forming organs group. Vitamin D3 and Calcium combination was the most commonly prescribed FDC. Approximately 20% of these prescribed drugs are currently banned.Conclusions: A significant number of drugs are being prescribed as FDCs which also includes various irrational combinations

Prescribing pattern of antimicrobials in various clinical departments of a tertiary care hospital

Background: Antimicrobials are one of the most commonly used group of drugs. Their overuse and inappropriate use is one of the major concerns today. Assessment of prescribing pattern of antimicrobials provides insight into the health consequences and helps update antimicrobial usage guidelines. Hence this study was conducted with an objective to analyse the prescribing pattern of the antimicrobials.Methods: A cross sectional study was conducted based on the prescriptions collected from Department of Pharmacy, Pondicherry Institute of Medical Sciences (PIMS), Puducherry. A total of 838 outpatient prescriptions were collected from four clinical departments, viz. General Medicine, General Surgery, Pediatrics and Obstetrics & Gynecology for a period of four months. The data collected were analysed using descriptive statistics.Results: Among 838 prescriptions 188 (22.43%) contained antimicrobials. Among the various departments, number of prescriptions with antimicrobials were more in department of General surgery (34.42 %) followed by Obstetrics & Gynecology (24.77 %). The commonly prescribed antibiotics were penicillins (25.47%), fluoroquinolones (12.73%), cephalosporins (10.84%), macrolides (8.96%), nitroimidazoles (6.60%) and tetracyclines (4.71%). Among the total antimicrobials, percentage of drugs prescribed by generic name and from National list of essential medicines (NLEM) were 38.20% and 80.18% respectively. Majority of antimicrobials (58.01%) were prescribed as oral tablets/ capsules.Conclusions: It was found that penicillins were the most commonly prescribed group of antimicrobials, significantly less number of antimicrobials were prescribed by generic name, 80.18% of antimicrobials were prescribed from NLEM and tablets/ capsules were the most common dosage forms

Fluid Flow Measurement Systems Using Hot Wire Anemometer

The hot-wire anemometer has been used continuously since a long time as a research tool in fluid mechanics. A thorough study of this process and detailed analysis of different technique in which this method can be enhanced has been done. In hot-wire anemometry a small electrically heated element(wire) exposed to a fluid medium for the purpose of measuring a property of that fluid medium is used. Usually, the property measured is the velocity. Since these elements are sensitive to heat transfer between the element and its environment, temperature and composition changes can also be sensed. Taking different types of probes and different types of fluid we compare the behavior of sensor so that we can determine the best condition for measurement of property particularly velocity

6-Amino-3,4-dimethyl-4-phenyl-2H,4H-pyrano[2,3-c]pyrazole-5-carbonitrile

In the title compound, C15H14N4O, the pyrazole ring is aligned at 88.23 (4)° with respect to the aromatic ring and at 3.75 (4)° with respect to the pyran ring. In the crystal, N—H⋯N hydrogen bonds link adjacent mol­ecules into a linear chain motif. C—H⋯N inter­actions are also observed

Radiological and functional outcomes of anterior bridge plating with minimally invasive plate osteosynthesis technique for humerus diaphyseal fractures in adults

Background: We conducted a study to evaluate radiological, functional outcomes and complications of internal fixation of humerus diaphyseal fractures by anterior bridge plating (ABP) with minimally invasive plate osteosynthesis technique. Methods: 40 patients with humerus diaphyseal fractures operated by ABP with MIPO between August 2017 and January 2020 were included in the study. All patients were evaluated verbally, clinically, and radiologically for a minimum of 1 year. Results: Mean time to radiological union was 13.75 weeks. Disabilities of the arm, shoulder and hand score improved from a mean of 23.45 to a mean of 5.04 at 6 months. All patients except one had an excellent Mayo Elbow Performance Score score at 6 months. The variation of mean shoulder range of motion between normal and operated side was within 5 degrees at 6 months. Visual Analogue Scale score improved from a preoperative mean of 8 to a postoperative mean of 0.5 at 6 months. Mean intraoperative blood loss was 147 ml. Two patients had a superficial wound infection, one patient had a postoperative radial nerve palsy, and one patient had a delayed union, all of which recovered without any surgical intervention. Conclusions: ABP with MIPO technique for humerus diaphyseal fractures is a safe and effective treatment modality yielding high rates of union, excellent functional recovery, minimal biological disruption, better cosmesis, and superior patient satisfaction. Therefore, we recommend that ABP with MIPO should be considered as an alternative treatment option in patients with humerus diaphyseal fractures