ABSTRACT
Endolymphatic sac tumour (ELST) is a non-metastasizing low grade adenocarcinoma of endolymphatic sac origin. It is also known as Heffner tumour, low grade adenocarcinoma of endolymphatic sac origin and aggressive papillary middle ear tumour. These tumours are closely associated with Von Hippel Lindau (VHL) disease. Here we report a case of Endolymphatic sac tumour in a 63 yr old lady who presented with left sided facial palsy. Since the tumour was highly vascular and required preoperative embolization, initial clinicoradiological diagnosis was Jugulotymphanic paraganglioma. Histopathology showed features of Endolymphatic sac tumour, which was confirmed by immunohistochemistry. Since this tumour is locally aggressive low grade adenocarcinoma, the diagnosis is difficult in advanced cases where there is erosion of petrous temporal bone or the lesion shows extension into cerebellopontine angle as in our case. Since the association of this tumour with VHL disease is well established, it is important to screen all the patients of VHL disease for this lesion and also all the patients of ELST should be screened for other lesions of VHL disease to aid in early diagnosis and treatment. The case is presented here for its rarity and difficulty in initial diagnosis.
ABSTRACT
Background: The objective of present study was to assess the drug utilization pattern among the geriatric patients. Methods: Totally, 150 prescriptions of patients’ ≥65 years admitted in the medicine inpatient department of MVJ Medical College and Research Hospital, Hoskote were noted from September 2013 to March 2014 and demographic profile, drug utilization pattern, commonly used drugs as per anatomical therapeutic chemical classification (ATC) and WHO core indicators were assessed after taking informed consent from the patients. Results: Out of 150 patients, average age of geriatric patients was 66.83 years with female preponderance (59%). Maximum number of patients were having respiratory disorders (66.67%) followed by diabetes mellitus (35.3%), and cardiovascular diseases (32.67%). 76% patients had co-morbid diseases like diabetes mellitus (n=53), hypertension (n=49), and chronic obstructive pulmonary disease (n=41). A total of 849 drug formulations, containing 1050 active ingredients, were prescribed with average number of 7 (1050/150) drugs per prescription. Only 70 formulations were prescribed by their generic names, which is less than that prescribed by their brand names 779 and total of 146 (17.19%) drugs were prescribed as fixed dose combinations. Only 45.47% drugs were according to WHO Essential Medicines List. Drugs acting on respiratory system (n=189) were the most commonly used drugs in our study followed by drugs acting on the gastrointestinal system (n=130), antimicrobials (n=113), cardiovascular system (n=112), endocrine (n=83), and nutritional supplements (n=72). Polypharmacy was prevalent in 62% and about 22.67% of patients received <5 drugs. Pantoprazole was most frequently prescribed drug followed by aspirin 75 mg, adrenergic, and anticholinergic bronchodilators. Conclusion: Thus, irrational prescribing and polypharmacy were prevalent among elderly. Drug utilization data can help in assessing the quality of care given to the geriatric patients and promote rational use of medicines.
ABSTRACT
Background: The magnitude of improvement seen with present conventional medicines for anxiety and depression remain disappointing thereby providing a scope for the study of newer drugs. In the literature, there is evidence demonstrating the modulation of N-methyl-D-aspartate (NMDA)receptors in anxiety and depression. The present study is undertaken to evaluate the antianxiety effect of memantine in elevated plus maze (EPZ) test and its antidepressant effect in tail suspension test (TST)in Swiss albino mice. Methods: Animals were divided into six groups (n=6). First group mice were given normal saline (10 ml/kg), second group were administered lorazepam (0.5 mg/kg), third group with memantine (3 mg/kg) and fourth group with memantine plus lorazepam, fi fth group was administered amitriptyline (10 mg/kg)and sixth group received memantine plus amitriptyline. All drugs were administered by intraperitoneal route daily for 7 consecutive days. Results were analyzed by one-way ANOVA followed by post-hoc Tukey’s test. Results: Memantine treated mice showed signifi cant increase (p<0.001)in time spent and number of entries in open arm and signifi cant decrease in time spent and number of entries in closed arm in EPZ when compared to control group. Duration of immobility was signifi cantly (p<0.001)reduced in animals treated with memantine when compared to the control group in TST. Conclusions: NMDA antagonist, memantine has showed signifi cant antianxiety effect in EPZ test and antidepressant effect in TST.