Prescription pattern of antimicrobial drugs in pediatrics outpatient department of a tertiary care teaching hospital of North India

Background: The pediatric population comprises of 20-25% of the total world population, and numerous acute and chronic diseases can effect this sub population. Antibiotics are among the most frequently prescribed classes of medications for children.Methods: The study is prospective interventional study carried out in the pediatric outpatient of the MIMS for a period of 3 months (September-November 2013+1 month for analysis).Results: Most (84%) children were given single antimicrobial agent and 16% were given more than one antimicrobial or fixed dose combination of the antimicrobial agent. Amoxicillin (48%), erythromycin (20%) and cefixime (16%) were found to be the most frequently used antibiotics.Conclusions: The high percentage of prescriptions involving antimicrobials observed in MIMS requires rational use of antimicrobials and judicious prescribing. It should be followed by the appropriate use of the selected medicine from the NLEM with frequent update of information. The implementation of antibiotic policy and treatment guidelines with periodic assessment of the clinical pharmacologist in the study area is very important in order to monitor the clinical use of these medications

Study of atomic collisions by charged particles

The Present study of collision processes involving positive ions provides a sensitive test of the approximate method to develop positron and electron scattering and yields useful information about the role of different works in collision dynamics. This study of laser assisted collision process involves an accurate description of the projectile and the target states in the presence of laser field.Â

Prescription pattern of analgesics in outpatient department in a tertiary care teaching hospital in North India

Background: Pain is an unpleasant sensory and emotional experience which is associated with actual or potential tissue damage or described in such terms. NSAIDs are most commonly prescribed drugs for the treatment of pain and inflammation and is most commonly prescribed drug around the world. NSAIDs are also most commonly used drug over the counter. Present study was done to evaluate the prescription pattern of analgesics and to assess the rational use of conventional non-steroidal anti-inflammatory drugs (NSAIDs), selective cyclooxygenase-2 (COX-2) inhibitors, and opioid analgesics.Methods: Present study was Cross sectional study, done at outdoor department of Orthopaedics at T.S. Misra Medical College and Hospital, Lucknow during January 2017 to April 2017 in a pre-designed and pre-tested proforma. Both male and female patients, above the age of 18 years, who were willing to participate in this study were enrolled. Samples of 253 prescriptions were screened randomly and verbal informed consent was taken. Data were analysed using MS Excel 2007 and summarized as counts and percentages. Statistical analysis was not done as it was a descriptive study.Results: Most commonly prescribed analgesics were non-selective NSAIDs followed by selective COX-2 inhibitors. Most commonly prescribed FDCs combination was diclofenac with paracetamol.Conclusions: This study shows that diclofenac is the most frequently prescribed analgesic in orthopaedics OPD at this hospital. The extensive use of irrational FDCs must be curtailed. We observed in present study that most of the prescriptions were rational. But there are scopes for improvement by introducing appropriate educational intervention for rational prescribing.

Incidence and location of deep vein thrombosis of lower extremity following surgery of tibial plateau fracture

Background: Tibial plateau fractures are commonly seen fractures of lower limb. They are challenging to manage since they are mostly associated with soft tissue injuries. Deep vein thrombosis (DVT) is a significant cause of morbidity and pulmonary embolism can even cause mortality in all hospitalized patients, especially after trauma and lower extremity fracture, which further carries risk of significant morbidity and mortality. We aim to evaluate the epidemiological characteristics of postoperative DVT in tibial plateau fractures.Method: A prospective observational randomized study was performed. A total of 79 patient were included in this study who had proximal tibia fractures. Pre-op ultrasonography was done and post operative ultrasonography was done following proximal tibia plating surgery on day 2. Successive evaluation with USG was done at week 2, week 3 and week 4 for DVT. If DVT is diagnosed it will be managed medically.Result: A total of 79 patients were included in the study, 28 were females and 51 males. 4 out of 79 patients were diagnosed with DVT following surgery of tibial plateau fracture. Predominantly DVT was seen in male patient of elderly age group who had high energy trauma operated by open reduction with duration of surgery of more than 1 hour. 3 out of 4 patients had distal DVT and 1 had proximal DVT.Conclusions: Six risk factors were found to be strongly associated with DVT i.e., old age, male gender, high energy trauma, increased preoperative interval, open reduction and prolonged duration of surgery. These epidemiologic data will be helpful in individual assessment, risk categorisation and development of targeted prevention programs

SIMULTANEOUS ESTIMATION OF PROPAFENONE AND ITS TWO METABOLITES IN HUMAN PLASMA BY LIQUID CHROMATOGRAPHY/TANDEM MASS SPECTROMETRY LC-MS/MS

Objective: A simple, sensitive and rapid performance liquid chromatography/positive ion electrospray tandem mass spectrometry method was to be developed and validated for quantification of propafenone (PPF) and its two major metabolite 5-hydroxy propafenone (5-OHP) and N-depropyl propafenone (NDP) in human plasma.Methods: Liquid-liquid extraction (LLE) with ethyl acetate was used of extraction of plasma samples. The analytes were separated using an isocratic mixture of 0.1% formic acid/acetonitrile (20:80 v/v) on a reversed-phase column Hypurity Advance C18 50 x2.1 mm, 5µ and analysed by mass spectrometry in the multiple reaction monitoring mode using the respective [M+H] Ions. The m/z was 342.20/116.10 for propafenone, m/z 299.80/74.10 for N depropyl propafenone and m/z 358.30/98.10 for 5-hydroxy propfenone along with m/z 409.2/238.0 for Amlodipine as internal standard respectively.Results: The method had a short chromatographic run time of 1.5 min. The method exhibited a linear dynamic range over 5.11 to 1000.73 ng/ml for propafenone, 0.51 to 100.06 ng/ml for N-depropyl propafenone and 5.11 to 1001.64 ng/ml for 5-hydroxy propafenone respectively, in human plasma.Conclusion: The validated method has been successfully used to analyze human plasma samples for application in pharmacokinetics, bioavailability and bioequivalence studies

An Uprateability Risk Assessment Methodology

Uprating is a process to assess the ability of a part to meet the functionality and performance requirements of the applications in which the part is used outside the manufacturers' specification range. However, uprating can be an expensive and time consuming process. There is also no guarantee that all parts can be successfully uprated. In 2002, some electronic part manufacturers began releasing a category of parts considered to be "closer" to military-grade parts, called "Enhanced Plastic (EP)". Since some of the EP parts offer a wider operating temperature range compared with the commercial parts, they are promoted by the EP part manufacturers as an alternative to uprating. This thesis evaluates the EP parts and finds that when EP parts are available in wider temperature range, they can be beneficial to the electronic system manufacturers as they do not require uprating. However, the availability of EP parts in wide operating temperature range is limited, and the cost is much higher. The thesis then provides a priori methodology to evaluate the uprateability of an electronic part, and in particular, eliminate parts that are unlikely to be successful in uprating. Four uprateability risk levels are defined which can be determined from the available part and system information during the part selection process. The method of analyzing the information to assign the risk levels is developed for both active and passive parts. Three case studies of uprateability risk assessment are then presented in the thesis - one for an operational amplifier and two for polymer film capacitors. Complete analysis beginning from manufacturer and part assessment through electrical test results analysis is performed to show the uprateability risk assessment process

A REVIEW OF ANALYTICAL TECHNIQUES FOR DETERMINATION OF ANTI-HIV DRUGS

Pharmaceutical analysis plays a very prominent role in quality assurance as well as quality control of bulk drugs and pharmaceutical formulations. Rapid increase in pharmaceutical industries and production of drug in various parts of the world has brought a rise in demand for new analytical techniques in the pharmaceutical industries. As a consequence, analytical method development has become the basic activity of analysis. From the times of yore, people were trying to find safe and sound ways to treat viral infections. In the current scenario, due to the emerging of new viruses, the development of drugs for their treatment is also gaining equal importance. Before launching to the market, these drugs should undergo a validation process. High-performance liquid chromatography (HPLC) coupled with ultraviolet (UV), Photodiode array detectors (PDA), Mass spectrophotometer (MS) detectors etc. is one of the fastest, safe and precise technologies used for determination and separation of pharmaceutical drugs, impurities and biological samples. HPLC is versatile and it takes less time for quantification of drugs as compared to old liquid chromatography techniques. Tenofovir disoproxil fumarate (TDF), Emtricitabine (FTC) and Efavirenz (EFV) is antiretroviral medicine used treat AIDS as well as chronic Hepatitis-B. It is used alone or with other HIV medications to help control HIV infection. The present review article assesses the published analytical methods and a variety of approach for investigation of TDF, FTC and EFV in bulk drug as well as pharmaceutical formulations including combinations. The present studies revealed that HPLC technique along with the spectroscopic have been most widely explored for the analysis. The investigatory review may provide the comprehensive details to the researchers who are working in the area of analytical research of TDF, FTC and EFV

Effect of Indoor Air Pollution on Child Development: A Research Review

The air quality of our indoor environments majorly affects our health. Children are the most exposed to indoor air pollutants as they spend most of their time at home and indoors, the quality of air becomes a major concern in their course of development. While in rural areas the major indoor pollutants are the emissions from combustion sources, in urban areas the particulates and polycyclic aromatic hydrocarbons (PAHs) have chronic and long-term effects. The aim of this study is to review the available literature dealing with various effects of child development. The study showed the relationship between prenatal exposure to airborne PAHs and Child IQ. Children were monitored from in utero to 5 years of age, with determination of prenatal PAH exposure through personal air monitoring for the mothers during pregnancy. It was found that high PAHs level were inversely associated with IQ. The other study comprehended lung development with exposure to nitrogen dioxide, acid aerosols, particulate matter and elemental carbon. Lung function tests were performed annually for 8 years among the children and a decrease in Forced Expiratory Volume (FEV) was observed. The results of the study indicated that current ambient levels of air pollution have chronic and adverse effects on lung development in children leading to significant deficits in FEV as these children reach adulthood. In rural India, the risks associated with indoor air pollution are found to be extremely high. The study revealed that most of the rural households were exposed to acute upper and lower infections, the reason being the use of traditional fuels and poorly ventilated cooking areas. The study focuses on creating awareness towards the adverse effects of indoor air pollution specifically on children health, with reference to the existing studies

Noise Pollution and its Enacting Laws in India

Never before in the history, has the environment pollution drawn such attention of policymakers, academicians and the court in India. The present concern for preservation and conservation of environment arises from the hazardous impact on the human actions. Human demands are increasing day by day with the growth of population and modernization. For a long time many individuals have accepted noise as a part of their environment. The development of various engines, technological machinery in industries, jet planes, automobiles etc all contributed to increasing noisy environment. Noise is now regarded by many people as a pollution component that contributes to deterioration of the environment. Noise pollution is infect a threat to million that could be as dangerous as the pollution of the atmosphere. The recently intensified effort to save the environment has succeeded impressively in bringing the subject to wide public notice. It has helped to identify problems and arise concern. But it has been deficient in solutions. For very good reason effective steps to save the environment will require a highly expert knowledge of governmental machinery, knowledge of political infighting, knowledge of how tough and enforceable legislation might be written and how such legislation has been systematically enacted. The focus of present day policies is to use emission free technologies to be useful in preserving and conserving precious natural environment