Drug utilisation study in a tertiary care center: recommendations for improving hospital drug dispensing policies.

Drug therapy accounts for a major portion of health expenditure. A useful strategy for achieving cost efficient healthcare is drug utilisation research as it forms the basis for making amendments in drug policies and helps in rational drug use. The present observational study was conducted to generate data on drug utilization in inpatients of our tertiary care hospital to identify potential targets for improving drug prescribing patterns.

Comparative evaluation of naftopidil and tamsulosin in the treatment of patients with lower urinary tract symptoms with benign prostatic hyperplasia.

Introduction: Naftopidil, approved initially in Japan, is an α1d-adrenergic receptor antagonist (α1-blocker) used to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). It is different from tamsulosin hydrochloride and silodosin, in that it has a higher affinity for the α1D-adrenergic receptor subtype than for the α1A subtype and has a superior efficacy to a placebo and comparable efficacy to other α1-blockers such as tamsulosin. The incidences of ejaculatory disorders and intraoperative floppy iris syndrome induced by naftopidil may also be lower than that for tamsulosin and silodosin, which have a high affinity for the α1A-adrenergic receptor subtype.

Clinical outcome and predictors of mortality in children with sepsis, severe sepsis, and septic shock from Rohtak, Haryana: A prospective observational study.

Background: Information regarding early predictive factors for mortality and morbidity in sepsis is limited from developing countries.

Methods: A prospective observational study was conducted to determine the clinical outcome and predictors of mortality in children with sepsis, severe sepsis, and septic shock. Children aged 1 month to 14 years admitted to a tertiary care pediatric intensive care unit (PICU) with a diagnosis of sepsis, severe sepsis, or septic shock were enrolled in the study.

Assessment of parent reported quality of life in children with epilepsy from Northern India: A cross-sectional study.

Objective: The objective of the following study is to assess parent reported quality of life (QOL) in children with epilepsy and to assess the demographic and clinical factors, which influence the QOL in children with epilepsy.

Study Participants: We consecutively enrolled 40 children aged from 2 years to 14 years with active epilepsy who had undergone a comprehensive evaluation for epilepsy.

Materials And Methods: Parents were enquired on baseline demographic variables including age, gender, socio-economic status and parental education.

Humeral diaphyseal osteochondroma causing median nerve injury.

Osteochondromas are the most common benign tumours of the bone. They are solitary or multiple, pedunculated or sessile exophytic outgrowths from the bone surface that are composed of cortical and medullary component with an overlying hyaline cartilage cap. Marrow and cortical continuity with the underlying parent bone is the characteristic of the lesion; they mostly arise from the metaphysis of the bone.

Antioxidant effect of isoflavones: A randomized, double-blind, placebo controlled study in oophorectomized women.

Background: One of the postulated mechanism for cardioprotective potential of isoflavones is their ability to exert antioxidant action. However, various reports give conflicting results in this area.

Aim: The present study was conducted with an objective to probe into the cardioprotective mechanism of isoflavones by evaluating their antioxidant potential in oophorectomized women.

Aluminum phosphide (celphos) poisoning in children: A 5-year experience in a tertiary care hospital from northern India.

Background: Aluminum phosphide (ALP) (celphos) is an agricultural pesticide commonly implicated in poisoning. Literature pertaining to the clinical manifestations and treatment outcome of its poisoning among children is limited.

Materials And Methods: A retrospective chart review was conducted of the medical records of 30 children aged less than 14 years admitted to pediatric intensive care unit (PICU) of a tertiary care hospital in northern India.

Solitary fibrous tumour of lung.

Fibrous tumours arising entirely within the substance of the lung are rare. We report one such rare case in whom the diagnosis was established after surgical removal.

Hypertension Vaccine may be a boon to millions in developing world.

Hypertension affects around 40% adults aged 25 years and more worldwide, and accounts for 7% of total disability-adjusted life-years. A simple algorithmic program is required to manage hypertension consisting of screening, life style measures, treatment and follow-up, a reliable drug supply and distribution system, and a credible health information system. Despite availability of effective antihypertensive drugs, long term treatment is still costly, tedious, and at the population level rather unsuccessful.

Role of the aromatase inhibitor letrozole in the management of uterine leiomyomas in premenopausal women.

Background: Uterine myomas are benign tumours affecting 20-40% women. Various medical and surgical therapeutic options are available but the search for an ideal medical option continues. Aromatase inhibitors have recently been reported to have a potential role in the management of oestrogen-dependent conditions like endometriosis and leiomyoma.

Evaluation of Integrated Management of Neonatal and Childhood Illness (IMNCI) algorithm for diagnosis and referral in under-five children.

A prospective observational study was conducted on 500 children to evaluate the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) algorithm for diagnosis and referral of children aged 0-59 mo. IMNCI algorithm performed well in diagnosis [except sepsis in 0-7 d (p < 0.01) and malaria in 2-59 mo (p < 0.

Longitudinal bracketed epiphysis of proximal phalanx of the great toe with congenital hallux varus managed simultaneously with monorail external fixator: a case report.

Longitudinal bracketed epiphysis (delta phalanx) is a rare congenital anomaly that affects phalanges in the hand more commonly than toes. We present a rare case of congenital hallux varus with longitudinal bracketed epiphysis of proximal phalanx with bifid distal phalanx of the great toe, which was managed with monorail type of external fixator. To the best of our knowledge, this is the first report of its successful implementation in simultaneous treatment of longitudinal bracketed epiphysis of the proximal phalanx of the great toe and hallux varus.

Clinical spectrum and treatment outcome of severe malaria caused by Plasmodium vivax in 18 children from northern India.

Objective: The study was intended to document the clinical profile and treatment outcome of severe malaria caused by Plasmodium vivax (P.vivax) in children hospitalized in a tertiary care centre of northern India.

Methods: This prospective observational study was performed among children admitted with severe malaria at a tertiary care referral hospital of northern India from January 2012 to December 2012.

Quality of life in symptomatic HIV infected children.

We conducted a case control study to compare the quality of life (QOL) in 40 cases of HIV infected children and 40 demographically matched controls with other chronic ailments at a referral hospital in Northern India. Quality of life among HIV infected children was significantly better in psychosocial (P=0.008), emotional (P=0.

Gap nonunion of tibia treated by Huntington's procedure.

Background: Gap nonunion that may occur following trauma or infection is a challenging problem to treat. The patients with intact or united fibula, preserved sensation in the sole, and adequate vascularity, were managed by tibialization (medialization) of the fibula (Huntington's procedure), to restore continuity of the tibia. The goal of this retrospective analysis study is to report the mid-term results following the Huntington's procedure.

Thyroid function tests in metabolic syndrome.

Objective: We evaluated the thyroid function tests in individuals with metabolic syndrome to explore the possibility of thyroid receptor resistance.

Materials And Methods: The study was a cross-sectional study. It included 40 patients (group I) and 20 healthy individuals served as controls (group II).

Subungual exostosis of the great toe: a case report and tumor overview.

Unlabelled: Subungual exostosis is an acquired, benign, and solitary bone tumor of the distal phalanx occurring beneath or adjacent to nail. A 18-year-old man presented with a lump, ulceration, and pain on his right big toe. This complaint was present for the past 2 years.

An approach to uropathogenic Escherichia coli in urinary tract infections.

Purpose: To study the occurrence and characterization of Uropathogenic Escherichia Coli (UPEC) in cases with urinary tract infections.

Materials And Methods: A total of 220 symptomatic cases from urinary tract infections and 50 stool samples from apparently healthy individuals were included. The colonies identified as Escherichia Coli were screened for virulence factors, that is, hemolysin, Mannose Resistant and Mannose Sensitive Hemagglutination (MRHA, MSHA), Cell surface hydrophobicity, and Serum resistance.

Xanthogranulomatous cystitis: A rare clinical entity.

Xanthogranulomatous cystitis (XC) is a rare benign disease of unknown etiology. A case of XC in a 30-year-old male is presented due to sparcity of such case report in medical literature. Patient evaluation included clinical, biochemical and radiological studies before treatment.

Management of female uro-genital fistulas: Framing certain guidelines.

Background: The study was carried out to discuss the pathogenesis and management protocol of seven different varieties of female uro-genital fistulas (FUGFs).

Patients And Methods: During 2000-2007, total of 15 FUGFs were operated, which belonged to seven different varieties requiring different routes and surgical procedures for their repair. Different fistulas with different pathophysiological factors required specific examinations and investigations preoperatively.

Comparison of isosorbide mononitrate and misoprostol for cervical ripening in termination of pregnancy between 8 and 12 weeks: a randomized controlled trial.

Aim: The present study was undertaken to compare the efficacy of isosorbide mononitrate (IMN) and misoprostol for cervical ripening in termination of pregnancy between 8 and 12 weeks.

Materials And Methods: This prospective randomized single blind study enrolled 40 women with singleton pregnancy seeking surgical termination of pregnancy between 8 and 12 weeks of gestation. They were divided into two groups--group I received IMN 40 mg while group II received misoprostol 40 mg vaginally, 3 h prior to suction and evacuation.

Lipoprotein-A and carotid intima media thickness as cardiovascular risk factors in patients of chronic kidney disease.

Patients in all stages of chronic kidney disease (CKD) are considered in the "high-risk group" for development of cardiovascular disease (CVD). The study was undertaken in 60 adult patients of chronic renal failure. The patients were divided into three groups: Group I had subjects with CKD (stages 1 and 2); Group II had subjects with CKD (stages 3 and 4) on conservative therapy for 3 months; and Group III had subjects with CKD (stage 5) on regular hemodialysis for at least 3-4 weeks.