Study on drug utilization pattern of antihypertensive medication in tertiary care hospital of Telangana, India

Background: Hypertension is leading cause of deaths in the world. It is the major risk factor for systemic disorders including cardiovascular, renal and brain disorders. A drug utilization review on antihypertensive drugs should be done to determine different classes of antihypertensive medications with respect to diagnosis. Aim was to study drug utilization pattern of antihypertensive medication in a tertiary care hospital, Telangana.Methods: A cross sectional observational study was done in the patients with hypertension for duration of one year i.e. from April 2017 to May 2018 in the department of Pharmacology at Mallareddy Narayana multispecialty hospital, suraram, Telangana. A total 130 Patients who were suffering with acute, chronic hypertension and admitted in general medicine department and undergoing antihypertensive treatment were included.Results: A Total of 130 patients with history of hypertension were included. majority of patients i.e., 46.1% (60/130) were among 51-60 years, followed by 24.6% (32/130) patients among 41-50 years., Male predominance 80/130 61.5%) compared to females 50/130 (38.4%). In the Present study, 105(80.7%) prescriptions had Monotherapy prescription and 25/130 (19.2%) has combination of two. The most frequently prescribed drug as monotherapy was Calcium Channel Blockers (CCBs) about 52.3%, Beta blockers constitute about 14.2%, and diuretics about 19%, 9.5% Angiotension Receptor Blockers (ARBs) and alpha-Adrenergic Blocker (AABs), 4.7% ACE inhibitors.Conclusions: Calcium channel blockers are the highest among the drugs that are used as monotherapy. In combination therapy, diuretic with angiotensin receptor blocker and calcium channel blocker with beta blocker are the frequently prescribed drugs

An Empirical Study on Innovative Business Strategies - Key to Progress in the Emerging Economies with Special Reference to Yes Bank

AbstractToday competing successfully in emerging markets has become the key to a good and effective corporate strategy and to grow and sustain profitably in these markets it is essential to opt for a strategy based upon innovation blended with entirely new set of skills, organizational structures, new concepts, products and services that serves to the specific requirements of the market, keeping in mind the cost factor. The objectives of the present research were: (i) To understand how the various innovative strategies like knowledge banking initiated by Yes Bank is helping the bank to progress and sustain its position in the Indian Banking sector and (ii) The customer's perception about the innovative products and services offered by Yes Bank. All the constructs were measured using Multiple Item Rating Scales. To ensure content validity the measures were assessed by five academics so that the respondents would understand the question correctly. To measure the innovativeness of the bank 20 variables have been considered for Branch Banking Services and 25 variables for the Corporate and Commercial Banking. Two sets of different questionnaires have been framed respectively. Total of 150 customers have been contacted for the research purpose. The data collected has been analyzed using various statistical tools to check the validity of the proposed hypothesis. The paper will throw light on the various innovative strategies adopted by Yes bank to sustain itself and to attain growth profitably. The paper also give an insight towards the customers’ perception towards the Bank's new concepts, products and services which makes the bank an Innovative Success in an emerging economy like India

A comparative study of total intravenous anesthesia with propofol/ketamine and propofol/tramadol combinations in orthopedic outpatient procedures

Background: Propofol opioid/nonopioid combinations provide adequate analgesia during and after surgery. The aim of this study was to compare the effect of anesthesia with propofol/ketamine versus propofol/tramadol on the haemodynamic parameters and pain in patients undergoing orthopaedic outpatient surgical procedures.Methods: Fifty patients with ASA status I-II between the age group of 20-50 years undergoing orthopaedic outpatient surgical procedures under general anesthesia were randomly assigned to propofol/ ketamine (n=25, group I) and propofol/ tramadol (n=25, group II) groups. Patients in group I were induced with propofol 150 μg/kg/min IV and ketamine 50 μg/kg/min IV and in group II induction was performed with propofol 150 μg/kg/min IV and tramadol 1 mg/kg/min. IV. The hemodynamic parameters, oxygen saturation (SpO2), respiration rate, sedation and pain were measured before and after induction at predefined time points and were compared between groups.Results: There was significant difference between groups in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR). SBP, DBP and HR were stable in patients induced with propofol/ketamine. The SBP, DBP and HR decreased significantly after induction with propofol/tramadol compared to premedication, but tends to return to normal after 25 minutes. No significant changes in SpO2 found in both the groups at all-time points. Both groups are sedated and showed no difference in pain score with few episodes of unpleasant dreams or hallucinations or adverse complications.Conclusions: Propofol/tramadol anesthesia in patients undergoing orthopaedic procedures provided stable hemodynamic and respiratory stability, sedation and pain reduction as effective as propofol/ketamine anesthesia

Comparative study of theophylline and doxofylline in the treatment of stable chronic obstructive pulmonary disease

Background: COPD is one of the major public health problems worldwide. Theophylline has been used in the treatment of COPD for decades. Doxofylline a new theophylline congener has been claimed to have better safety profile. The study was undertaken to compare theophylline and doxophylline at doses recommended and commonly used in clinical practice.Methods: The study was conducted in patients of COPD in TB chest department of Osmania medical college hospital. It was an open label, randomized, prospective parallel group study of 12 weeks duration. A total of 40 patients were divided in two groups. Group I was administered 400 mg theophylline sustained release tablets once daily orally and group II was administered doxofylline 400 mg twice a day orally. Spirometric variables symptom score, and adverse effects were recorded on days 0, week 1, week 6 and 12 of therapy. Data were compared and statistical analysis was performed using the Prism Graphpad 6, USA.Results: There was no statistically significant difference with respect to spirometric variables and symptom score in the two groups and no significant difference in two groups with respect to side effects (p>0.05).Conclusions: Both doxofylline and theophylline significantly improved spirometric values and there was significant improvement in symptoms – cough, shortness of breath and nocturnal severity of symptoms. There was a significant reduction in the use of at rescue medication during the treatment with both the drugs

Molecular Simulation of MoS2 Exfoliation.

A wide variety of two-dimensional layered materials are synthesized by liquid-phase exfoliation. Here we examine exfoliation of MoS2 into nanosheets in a mixture of water and isopropanol (IPA) containing cavitation bubbles. Using force fields optimized with experimental data on interfacial energies between MoS2 and the solvent, multimillion-atom molecular dynamics simulations are performed in conjunction with experiments to examine shock-induced collapse of cavitation bubbles and the resulting exfoliation of MoS2. The collapse of cavitation bubbles generates high-speed nanojets and shock waves in the solvent. Large shear stresses due to the nanojet impact on MoS2 surfaces initiate exfoliation, and shock waves reflected from MoS2 surfaces enhance exfoliation. Structural correlations in the solvent indicate that shock induces an ice VII like motif in the first solvation shell of water

Photoelasticity of sodium silicate glass from first principles

Based on density-functional perturbation theory we have computed the photoelastic tensor of a model of sodium silicate glass of composition (Na$_2$O)$_{0.25}$(SiO$_2$)$_{0.75}$ (NS3). The model (containig 84 atoms) is obtained by quenching from the melt in combined classical and Car-Parrinello molecular dynamics simulations. The calculated photoelastic coefficients are in good agreement with experimental data. In particular, the calculation reproduces quantitatively the decrease of the photoelastic response induced by the insertion of Na, as measured experimentally. The extension to NS3 of a phenomenological model developed in a previous work for pure a-SiO$_2$ indicates that the modulation upon strain of other structural parameters besides the SiOSi angles must be invoked to explain the change in the photoelstic response induced by Na

Dynamic Transition in the Structure of an Energetic Crystal during Chemical Reactions at Shock Front Prior to Detonation

Mechanical stimuli in energetic materials initiate chemical reactions at shock fronts prior to detonation. Shock sensitivity measurements provide widely varying results, and quantum-mechanical calculations are unable to handle systems large enough to describe shock structure. Recent developments in reactive force-field molecular dynamics (ReaxFF-MD) combined with advances in parallel computing have paved the way to accurately simulate reaction pathways along with the structure of shock fronts. Our multimillion-atom ReaxFF-MD simulations of l,3,5-trinitro-l,3,5-triazine (RDX) reveal that detonation is preceded by a transition from a diffuse shock front with well-ordered molecular dipoles behind it to a disordered dipole distribution behind a sharp front

Impact of menstrual cycle phases on C-reactive protein concentrations

Background: C-reactive protein (CRP) is one of the most commonly employed indicator of acute phase reaction and predictors of cardiovascular disease in healthy women; although, only a sparse information on its variations during a regular menstrual cycle is currently available. Our objective was to see whether CRP levels are affected during different phases of menstrual cycle.Methods: Females aged 15-45 years with regular menstrual cycle in terms of length, flow and variation from cycle to cycle were followed for one menstrual cycle. Serum levels of C-reactive protein were measured in the Follicular (10th day) and in the Luteal (22nd day) phase of the menstrual cycle.Results: C-reactive protein levels were observed to vary in response to the phases of menstrual cycle. The concentrations of C-reactive protein levels tend to be highest during the Follicular phase and it declined significantly in the Luteal phase.Conclusions: Identifying the fluctuations in C-reactive protein levels during the menstrual cycle is essential as there may be clinical implication of the suitable timing of assessment while framing and concluding studies in women of reproductive age

Quantum Friction in Nanomechanical Oscillators at Millikelvin Temperatures

We report low-temperature measurements of dissipation in megahertz-range, suspended, single-crystal nanomechanical oscillators. At millikelvin temperatures, both dissipation (inverse quality factor) and shift in the resonance frequency display reproducible features, similar to those observed in sound attenuation experiments in disordered glasses and consistent with measurements in larger micromechanical oscillators fabricated from single-crystal silicon. Dissipation in our single-crystal nanomechanical structures is dominated by internal quantum friction due to an estimated number of roughly 50 two-level systems, which represent both dangling bonds on the surface and bulk defects.Comment: 5 pages, two-column format. Related papers available at http://nano.bu.ed