Patterns of Medication Use and Their Determinants in Pregnancy among Women Admitted to the Obstetrics Wards of a Tertiary Care Hospital: A Cross-Sectional Study: Patterns of Medication Use and Their Determinants in Pregnancy

Objective To assess the patterns and factors affecting medication use during antenatal and perinatal periods and to examine maternal and fetal outcomes among pregnant women admitted to a tertiary care hospital in a developing country. Methods A cross-sectional study was conducted in the obstetrics wards from 2017 to 2019. Data on patient demographics, co-existent medical conditions, medications, and patient outcomes were collected. Descriptive statistics were used to analyze baseline data, chi-square test was used for categorical variables, and multivariate logistic regression was used for factors influencing drug prescription. Results Out of 442 pregnant women, 56% were primigravida with a mean age of 24.7 ± 3.9 years. Approximately 32% experienced at least one disease condition during pregnancy; hypothyroidism (9.7%) was the commonest. The mean number of medications was 2.7 and 38.9% received drugs for a disease condition. Antimicrobials (24.5%) were the commonest drug class. Maternal age of over 25 [(OR (CI): 1.508 (1.191–2.716) (p = .005)] and maternal illness [OR (CI) 2.934 (1.8–4.7) (p = .00)] were identified as factors affecting drug prescription. Approximately 39.8% of deliveries were cesarean. Of the newborns, 12.6% had low birth weight, 9.2% were admitted to the newborn intensive care unit, and 14.9% were premature. Conclusions Most patients were primigravida and under 25 years. Antimicrobials were the most prescribed drug class. Maternal age over 25 years and maternal illness were identified as the factors affecting medication use. The prevalence of cesareans and prematurity was similar to previous studies.

A Comparative Clinical Study On Application Of Yashada Bhasma Lepa And Jatyadi Ghrita In The Management Of Dushta Vrana W.s.r. Diabetic Ulcer

Introduction: Wounds and their management are fundamental to the practice of surgery. In surgery of trauma, wound is frequently a primary pathology. In elective surgery, it is through the wound that access is obtained to deal with the underlying pathology. In both situations surgeon’s task is to minimize the adverse effects of wound, remove or repair damaged structures and harness the process of wound healing to restore function. Objectives: The study is aimed to know the comparative efficacy of Yashada Bhasma Lepa and Jatyadi Ghrita in the management of Dushta Vrana. Method: Clinically diagnosed 30 patients of Dushta Vrana were randomly divided into two groups, each group consisting of 15 Patients. First (A group) is treated by Yashada Bhasma Lepa and second (B group) is treated by Jatyadi Ghrita for 21 days. Result: On the basis of assessment criteria and on the overall result of treatment the patients of Yashada Bhasma Lepa group showed better relief when compared to Jatyadi Ghrita. Interpretation: Yashada Bhasma Lepa having the properties of Tikta, Kashaya, Katu, Rasa predominance thus had action of Kapha Pitta Shamana, Netra Roga, Pandu, Bahumootra Roga, Kasa, Swasa, Rajayakshma, Ratrisweda, Vranasrava Avarodaka,Prameha, Sankochakara.etc. Thus this help for Shodhanaand Ropana. Conclusion: Yashada Bhasma Lepa has provided better relief in maximum signs and symptoms of the patients of Dushta Vrana, in comparison to Jatyadi Ghrita. Its overall effects were also better in comparison to Yashada Bhasma Lepawith Jatyadi Ghrita and dressing reduces the infection.

Prospective study of outcomes of surgically treated larynx and hypopharyngeal cancers.

OBJECTIVE: To determine the morbidity and survival of surgically treated locally advanced carcinoma larynx and hypopharynx in a tertiary referral center in South India, a prospective cohort study was carried out. MATERIALS AND METHODS: Patients who had undergone laryngectomy or laryngopharyngectomy from January, 2006 to January, 2011 at our institute were prospectively studied for factors affecting morbidity tumor recurrence and disease free survival (DFS). DFS was calculated for the whole group and for the larynx and hypopharynx cancer subgroups separately, using Kaplan Meir Method and the survival differences of the larynx and hypopharynx groups and between salvage and primary surgical cases were evaluated using the Cox’s regression scale. RESULTS: A total of 154 patients with ages ranging from 23 to 78 (mean 56.3 + standard deviation 9.2) were studied, which included 145 males and 9 females. Pre‑operative tracheostomy and previous radiotherapy were the most significant factors contributing to post‑operative morbidity. Survival difference between the larynx and hypopharynx cancers was statistically significant and the DFS was significantly affected by primary site wound infection, primary site margin and node positivity. CONCLUSION: The results of laryngectomy can be optimized by “proper case selection and morbidity risk assessment”.

Formulation and evaluation of transdermal patches and to study permeation enhancement effect of eugenol.

Since oral bioavailability of Propranolol Hydrochloride is poor due to high first pass metabolism different matrix- type transdermal patches incorporating Propranolol Hydrochloride were formulated with an objective to study the effect of polymers on transdermal release of the drugs. The polymers selected for sustaining the release of drug were polyvinylpyrrolidone, Hydroxypropylmethycellulose (HPMC) and Ethyl cellulose (EC). The patches were formulated using combination of polymers and propylene glycol as plasticizer. The physicochemical evaluation of the polymer matrices was performed for suitability. In vitro permeation studies were performed using rat abdominal skin as the permeating membrane in Franz diffusion cell. The result indicated that maximum release was obtained at 2% solution of EC. Optimized batch was evaluated for permeation enhancement through rat skin using natural permeation enhancer Eugenol and it was concluded that permeation enhancement through Eugenol was comparable to the commercially available permeation enhancer Dimethyl sulfoxide 1% (DMSO). All the films were found to be stable at 37ºC and 45ºC with respect to their physical parameters and drug content.

Effects of socio-economic and demographic factors in delayed reporting and late-stage presentation among patients with breast cancer in a major cancer hospital in South India.

OBJECTIVE: We analyzed the distribution of socio-economic and demographic (SEDs) factors among breast cancer patients and assessed their impact on the stage at diagnosis of the disease and symptom duration. METHODS: Data for the year 2006 was collected from the Hospital Based Cancer Registry, Regional Cancer Centre (RCC), Trivandrum, Kerala, India. Patients (n=522) were included if they were from native Kerala state or adjoining Tamil Nadu. SEDS factors included age, residing district, religion, marital status, income, education and occupation. Other study variables were menopausal status, parity, listed symptoms with duration and stage at diagnosis. Association between SEDs factors by stage at diagnosis and duration of symptoms was tested using chi-square statistics, with odds ratios (OR) estimated through logistic regression modeling. RESULTS: Forty-five percent were reported at early stages and 53% at late stages. Elevated risks for late stage reporting among breast cancer patients were observed for women who were unmarried (OR=3.31; 95%CI: 1.10-9.96), widowed/divorced (OR=1.46; 95%CI: 0.89-2.37), with lower education (OR=2.72; 95%CI: 1.06-7.03 for illiterate women and OR=2.32; 95%CI: 1.05-5.13 for women with primary school education and OR=2.07; 95%CI: 1.02-4.21 for women with middle school education) and post-menopausal women (OR=1.45; 95%CI: 0.97-2.19). CONCLUSIONS: This analysis helped to identify the target population group for receiving health education for early detection of breast cancer.

Impact of socio-economic factors in delayed reporting and late-stage presentation among patients with cervix cancer in a major cancer hospital in South India.

The impact of socio- economic and demographic status (SEDS) factors on the stage of cervical cancer rat diagnosis, symptom duration and delay-time from diagnosis to registration was determined by analysing data for the year 2006 from the Regional Cancer Centre (RCC), Trivandrum, Kerala, India. Patients (n=349) were included if they were from the states of Kerala or Tamil Nadu. SEDS factors included age, residing district, religion, marital status, income, education and occupation. Associations between SEDS factors by stage at diagnosis and symptom duration were tested using chi-square statistics with odds ratios (OR) estimated through logistic regression modeling. Elevated risks for late stage reporting among cervical cancer patients were observed for women who were widowed/divorced (OR=2.08; 95%CI: 1.24-3.50) and had a lower education (OR=2.62; 95%CI:1.29-5.31 for women with primary school education only). Patients who had symptoms of bleeding/bleeding with other symptoms (77%) were more likely to seek treatment within one month, compared to patients with other symptoms only (23%) (p=0.016). This analysis helped to identify populations at increased risk of diagnosis at later stages of cancer with the ultimate intent of providing health education and detecting cancer at earlier stages.

Oligodendroglioma: clinical profile and treatment results.

Oligodendrogliomas are rare glial tumors with a long natural history. Radical surgery, postoperative radiotherapy, chemotherapy and observation have been suggested as part of primary management. This series reports the presentation and outcome in 34 patients with histologically verified pure oligodendrogliomas treated between 1983 and 1993. All patients were treated at the time of initial diagnosis with surgery, with or without additional radiotherapy. The overall survival and progression free survival rates at five years were 69.8% and 55% respectively. There was no tumor or treatment related factor influencing survival significantly.

Impact of psychological stress, gender and colour on visual response latency.

The measure of visual reaction time has been used to evaluate the processing speed of Central Nervous System and the co-ordination between the sensory and motor systems. As the reaction time is influenced by different factors, the impact of psychological stress, gender effect and the colour of objects in modulating the reaction time have been investigated in this study. 32 male and 38 female medical students in the age group of 18-21 yrs participated as subjects. It was observed that a) the males had a visual reaction time lesser than their female counterparts b) response latency for green colour was lesser than that for red in both the males and the female subjects and c) psychological stress resulted in a significant decline in the reaction time to green colour in males. The longer reaction time in females could be due to the effect of female sex hormones, which reduced the velocity of nerve impulse and increased the synaptic delay. Green colour evoked a faster response due to its stronger stimulation on the visual receptors.

Detection of HIV infection in pulmonary tuberculosis patients.

Well documented 112 pulmonary tuberculosis patients were studied for the prevalence of human immunodeficiency virus (HIV) seropositivity by using two antibody screening tests along with western blot test. Nineteen of the pulmonary tuberculosis patients were HIV seropositive, 12 were acid-fast bacillus smear positive; 12 patients were tuberculin skin test positive and 15 patients were culture positive. As the incidence of HIV infection is increasing in India, it is observed that patients co-infected with HIV and TB are also on the rise. Recognition of the dual infection and taking adequate steps to deal with this epidemic are needed.