A prospective observational study of prescription pattern of topical steroids in dermatology OPD, BRIMS, Bidar, India

Background: In dermatology practice Glucocorticoids are the most commonly prescribed drugs. Steroids produce dramatic relief in inflammatory and pruritic skin conditions, if they are irrationally used they may lead to adverse effects. Hence this study was done to observe the prescription pattern of corticosteroids.Methods: It was a prospective observational study. The prescriptions of patient attending the dermatology OPD were screened for the usage of the corticosteroids. The demographic data, chief complaints, diagnosis and the details of the drugs were collected and analysed.Results: Out of 415 patients screened, 13.97% were prescribed corticosteroids. Corticosteroids prescribed by generic name were 26.01% and brand name was 82.05%. Corticosteroids alone were prescribed in 42.02% and along with antihistaminics/antibiotics/emollients in 66.04%. Corticosteroids were prescribed topically in 86.02% of patients and systemically in 22.04% of patients. Moderately potent steroids prescribed in 80.42% followed by potent (15.07%) and very potent steroids (12.56%). No fixed dose combination drugs were prescribed.Conclusions: The corticosteroids prescribed by brand names (82.05%) were more than generic names (26.01%), information about the strength of the steroid was not mentioned and usage of emollients was less. This indicates the need for continuous medical education for the clinicians

Efavirinz induced gynecomastia: a case report

Gynecomastia is swelling of the breast tissue in men, caused by an imbalance of the hormones, estrogen and testosterone. Drugs commonly implicated are spironolactone, cimetidine, ketoconazole, hGH, estrogens, hCG, anti-androgens, GnRH analogues and 5-α reductase inhibitors. Medications probably associated with gynecomastia include risperidone, verapamil, nifedipine, omeprazole, alkylating agents, HIV medications (efavirenz), anabolic steroids, alcohol and opioids. HIV infected patients who are treated with highly active antiretroviral therapy (HAART) can develop breast enlargement due to benign and malignant mammary diseases. We report here a case of gynecomastia due to efavirinz

Predictors of Antibiotics Co-prescription with Antimalarials for Patients Presenting with Fever in Rural Tanzania.

Successful implementation of malaria treatment policy depends on the prescription practices for patients with malaria. This paper describes prescription patterns and assesses factors associated with co-prescription of antibiotics and artemether-lumefantrine (AL) for patients presenting with fever in rural Tanzania. From June 2009 to September 2011, a cohort event monitoring program was conducted among all patients treated at 8 selected health facilities in Ifakara and Rufiji Health and Demographic Surveillance System (HDSS).It included all patients presenting with fever and prescribed with AL. Logistic regression was used to model the predictors on the outcome variable which is co-prescription of AL and antibiotics on a single clinical visit. A cohort of 11,648 was recruited and followed up with 92% presenting with fever. Presumptive treatment was used in 56% of patients treated with AL. On average 2.4 (1 -- 7) drugs was prescribed per encounter, indicating co-prescription of AL with other drugs. Children under five had higher odds of AL and antibiotics co-prescription (OR = 0.63, 95% CI: 0.46 -- 0.85) than those aged more than five years. Patients testing negative had higher odds (OR = 2.22, 95%CI: 1.65 -- 2.97) of AL and antibiotics co-prescription. Patients receiving treatment from dispensaries had higher odds (OR = 1.45, 95% CI: 0.84 -- 2.30) of AL and antibiotics co-prescription than those from served in health centres even though the deference was not statistically significant. Regardless the fact that Malaria is declining but due to lack of laboratories and mRDT in most health facilities in the rural areas, clinicians are still treating malaria presumptively. This leads them to prescribe more drugs to treat all possibilities

Transport lattice models of heat transport in skin with spatially heterogeneous, temperature-dependent perfusion

BACKGROUND: Investigation of bioheat transfer problems requires the evaluation of temporal and spatial distributions of temperature. This class of problems has been traditionally addressed using the Pennes bioheat equation. Transport of heat by conduction, and by temperature-dependent, spatially heterogeneous blood perfusion is modeled here using a transport lattice approach. METHODS: We represent heat transport processes by using a lattice that represents the Pennes bioheat equation in perfused tissues, and diffusion in nonperfused regions. The three layer skin model has a nonperfused viable epidermis, and deeper regions of dermis and subcutaneous tissue with perfusion that is constant or temperature-dependent. Two cases are considered: (1) surface contact heating and (2) spatially distributed heating. The model is relevant to the prediction of the transient and steady state temperature rise for different methods of power deposition within the skin. Accumulated thermal damage is estimated by using an Arrhenius type rate equation at locations where viable tissue temperature exceeds 42°C. Prediction of spatial temperature distributions is also illustrated with a two-dimensional model of skin created from a histological image. RESULTS: The transport lattice approach was validated by comparison with an analytical solution for a slab with homogeneous thermal properties and spatially distributed uniform sink held at constant temperatures at the ends. For typical transcutaneous blood gas sensing conditions the estimated damage is small, even with prolonged skin contact to a 45°C surface. Spatial heterogeneity in skin thermal properties leads to a non-uniform temperature distribution during a 10 GHz electromagnetic field exposure. A realistic two-dimensional model of the skin shows that tissue heterogeneity does not lead to a significant local temperature increase when heated by a hot wire tip. CONCLUSIONS: The heat transport system model of the skin was solved by exploiting the mathematical analogy between local thermal models and local electrical (charge transport) models, thereby allowing robust, circuit simulation software to obtain solutions to Kirchhoff's laws for the system model. Transport lattices allow systematic introduction of realistic geometry and spatially heterogeneous heat transport mechanisms. Local representations for both simple, passive functions and more complex local models can be easily and intuitively included into the system model of a tissue

Teaching fire science and fire protection engineering to building engineering students

In order to train fire protection engineers, many complete undergraduate and graduate programs in fire science have been developed. However, there are few credit courses that provide a broad overview of fire protection engineering for students in other fields of engineering. This paper describes an introductory course in fire science and fire protection engineering that was developed for building engineering students at Concordia University in Montreal. The process for selecting material for this particular course is discussed, along with the importance of videotape, fire test data, laboratory tours and the internet. The roles of fire libraries and information centres are also discussed, as well as suggestions as to how to improve the course in the future.On a mis au point de nombreux programmes complets de premier et de deuxi\ue8me cycles en science de la s\ue9curit\ue9 incendie dans le but de former des ing\ue9nieurs sp\ue9cialis\ue9s dans ce domaine. Toutefois, il n?existe que peu de cours \ue0 unit\ue9s (cr\ue9dits) qui donnent une vue d?ensemble assez vaste de la technique de la protection contre l?incendie pour les \ue9tudiants d?autres champs d?ing\ue9nierie. Ce document d\ue9crit un cours d?introduction en science de la s\ue9curit\ue9 incendie et en technique de la protection contre l?incendie qui a \ue9t\ue9 mis sur pied pour le b\ue9n\ue9fice des \ue9tudiants en ing\ue9nierie du b\ue2timent de l?Universit\ue9 Concordia, \ue0 Montr\ue9al. On examine le processus de s\ue9lection du mat\ue9riel pour ce cours en particulier, de m\ueame que l?importance des documents vid\ue9o, des donn\ue9es des essais de r\ue9action au feu, des visites guid\ue9es de laboratoire et des sites Internet. On traite \ue9galement des diff\ue9rents r\uf4les que jouent \ue0 cet \ue9gard les biblioth\ue8ques de la s\ue9curit\ue9-incendie et les centres d?information, ainsi que des suggestions d?am\ue9liorations \ue9ventuelles pour le cours.Peer reviewed: NoNRC publication: Ye

When should I replace my turnout gear? IRC research projects on protective clothing and other fire service- related topics

Peer reviewed: NoNRC publication: Ye

IRC helping to develop guidelines for the retirement of firefighters' protective clothing

Also appeared in Fire and Flammability Bulletin, Dec. 1997, p. 2Peer reviewed: NoNRC publication: Ye

Effects of variations in thermal properties on the performance of flame resistant fabrics for flash fires

A numerical model of heat transfer in thermal protective fabrics under high heat flux conditions is used to determine the effects of varying individual thermal properties and boundary conditions on the predicted performance of single layer fabrics during bench top tests simulating flash fire conditions. The fabric thermal properties with the largest effects are thermal conductivity and specific heat the boundary conditions. i. e., flame temperature and emissivity and convective heat transfer coefficient, have an even larger effect on predicted bench top test results. The results of the parametric studies are described in this paper, along with a discussion about how these results may be used to design thermal protective fabrics.Un mod\ue8le num\ue9rique de transfert de chaleur dans les tissus de protection thermique en conditions de flux de chaleur \ue9lev\ue9 est utilis\ue9 pour d\ue9terminer les incidences qu?a la variation des propri\ue9t\ue9s thermiques individuelles et des conditions aux limites sur la performance pr\ue9dite des tissus monocouche au cours d?essais au banc simulant des conditions d?embrasement \ue9clair. Les propri\ue9t\ue9s thermiques des tissus ayant les incidences les plus marqu\ue9es sont la conductibilit\ue9 thermique et la chaleur massique. Les conditions limites, soit la temp\ue9rature et le pouvoir \ue9missif de la flamme, ainsi que le coefficient de transfert de chaleur par convection, ont une incidence encore plus grande sur les r\ue9sultats pr\ue9dits des essais au banc. Les r\ue9sultats des \ue9tudes param\ue9triques sont d\ue9crits dans le pr\ue9sent document, et on y trouve \ue9galement un expos\ue9 de la fa\ue7on dont on peut utiliser ces r\ue9sultats pour concevoir des tissus de protection thermique.Peer reviewed: YesNRC publication: Ye

Numerical models for use in the design of protective clothing for firefighters

Peer reviewed: YesNRC publication: Ye