A prospective and retrospective study on conservative management of hepatic and splenic injury following blunt abdominal trauma

Background: worldwide road traffic accidents accounts as the leading cause of death of young people. For a very long time most of the intra-abdominal injuries following blunt abdominal trauma were managed operatively. Conservative management is becoming more acceptable and effective management option for blunt abdominal trauma during the last few decades.Methods: This study was conducted in Government Medical College, Kottayam during September 2007 to December 2008. All conservatively managed blunt abdominal trauma patients during the study period were included in the study.Results: Out of 22 patients, 4 patients failed conservative management. Success rate was 81%. Most commonly injured solid organ in the study group was liver (77%). Maximum cases were of age group 10 to 20 (31.81%) years. 81% of patients were males. Motor vehicle accident was the most common cause of trauma (77%). Mean stay in intensive care unit was 4.2 days and mean hospital stay was 15.7 days. Mean systolic blood pressure was 110 mmHg ranging from 70 to 130 mmHg. 50% of patients had moderate hemoperitoneum and non-had massive hemoperitoneum.Conclusions: Non operative management is safe and effective approach in blunt spleen and liver injuries. Non operative management should be treatment of choice for all hemodynamically stable patients with blunt liver and splenic trauma.

A study to assess the unmet need for contraception among married women in the urban field practice area of a medical college

Background: The concept of unmet need for family planning points to the gap between some women’s reproductive intentions and their contraceptive behaviour. The National Population policy (NPP) 2000 states that the immediate objective is to address the unmet need for contraceptive services. Unintended pregnancy related to unmet need is a worldwide problem that affects women and their families and societies at large.Methods: A community based cross-sectional study was conducted from November 2016 to October 2017 in Maralur and Maralur Dinne, urban localities under urban health Training Centre of Sri Siddhartha Medical College. 260 Married women (15–49 years) were interviewed by house to house survey. The questionnaire was used to collect data to assess their reproductive intentions and contraceptive behaviour.Results: Out of 260 participants, 144 (55.4%) of them belonged to the group where their contraceptive needs were met for spacing and limiting births, 59 (22.69%) of them of did not have any need for contraceptives, 16 (6.15%) had unmet need for spacing births and 41 (15.77%) of the participants had unmet need for limiting births.Conclusions: The unmet need for contraceptives was 21.92% in the study which is much higher compared to NFHS-4 data for urban India (12.1%). The reasons and the factors associated with the unmet need should be addressed.

Analysis Of Femoral Neck Anteversion In Dry Adult Bones: A Morphometric Study

Introduction: The femoral neck anteversion can be defined as the angle between femoral bicondylar plane and aplane passing through the centre of the neck and head of femur. Adult femoral anteversion has been documentedat the range between 7-16 degrees.This angle is widely recognized as an important factor for hip stability. Thepresent study aimed to evaluate the normal anteversion range in adult Indian femur which would be of great helpin explorative orthopedic procedures and in designing of hip prosthesis.Materials and Methods: Study conducted in 202 femurs of 94 male (48 right and 46 left) and 108female bones (52right and 56 left). And the angle was measured using Kingsley Olmsted Method.Observation and Results: The mean value of anteversion angle of femurwas 7.61 degrees for male and 12.71degrees for females.Mean anteversion angle for both male and female femur was 10.37 degrees. Retroversionwas observed in 10 femurs(5%) and neutral version was observed in12 femurs (5.9%).Conclusion:Determining the anteversion angle is crucial for the diagnostic and therapeutic planning of patientswith various pathologies such as hip development dysplasias, cerebral palsy, varum thigh, flat thigh,epiphysiolysis, congenital club foot, congenital dislocation of the hipand other development abnormalities.Statistical analysis revealed sexual dimorphism in anteversion in Indians being greater among females thanmales

An observational study to monitor cutaneous adverse drug reaction profile in Dermatology Department of tertiary care teaching hospital

Background: Incidence of cutaneous adverse drug reactions (CADRs) in developed countries is 1 to 3% and in developing countries, it is much higher i.e. 2 to 6%. 1 in 1000 hospitalized patients will develop severe cutaneous adverse reaction. Maculopapular rash represents majority of cutaneous drug reaction followed by urticaria. Most frequently elicited CADRs are associated with antimicrobials and NSAIDs. This study was designed to monitor Cutaneous adverse drug reaction profile of tertiary care teaching hospital.Methods: This is a prospective observational study of 6 months� duration to monitor cutaneous adverse drug reactions in dermatology department of tertiary care teaching hospital. CADRs were analysed with respect to demographic details, suspected drugs and type of reaction. Causality assessment is by Naranjo algorithm. Data is represented in tables and graphs. Data is analyzed in Microsoft excel 2007.Results: Total 57 cases of cutaneous adverse drug reactions were reported. Among them, 57.9% were in males and 42.1% were in females. Majority of CADRs were due to antiretroviral drugs (38.5%) followed by antibacterial (28%) and antiepileptics (14%). Maculopapular rash is most common CADR (35%). Causality of 74% CADRs were probable according to Naranjo algorithm.Conclusions: CADRs are more commonly associated with antiretroviral therapy (ART), antibacterial drugs and antiepileptic drugs. In case of ART, antiepileptic drug and drugs used in chronic illness compliance plays a major role in the success of therapy. Adverse drug reactions lead to problem of non compliance and failure of therapy. Cutaneous adverse reactions like FDE heal with hyper pigmentation leads to cosmetic problem. Stevens Johnson syndrome (SJS) is life threatening that requires prompt withdrawal of drug and intensive medical management. Many drugs are available without prescription in India leading to problem of misdiagnosis of CADRs. So, data obtained from this study helps in proper diagnosis and treatment of CADRs.

Monitoring, evaluation and comparison of adverse effect profile of ciprofloxacin and ofloxacin in acute bacterial exacerbation of chronic bronchitis patients attending pulmonology department of tertiary care teaching hospital: a prospective observational study

Background: In 2016, FDA recommended that 搒erious side effects associated with flouroquinolones generally outweigh the benefits for the patients with acute sinusitis, acute bronchitis and uncomplicated UTI�. Throughout India the most commonly used flouroquinolones for above conditions are Ciprofloxacin, Ofloxacin, and Levofloxacin. In this scenario, the present study was undertaken to monitor, evaluate and compare the adverse effect profile of Ciprofloxacin and Ofloxacin in acute exacerbation of chronic bronchitis patients.Methods: Prospective, observational study done in 200 patients of tertiary care teaching hospital. The patients diagnosed with, acute bronchitis treated with Ciprofloxacin 500mg BD or Ofloxacin 400mg BD for 7 days were included in the study. The study duration was 6 months. ADR causality assessment was done with Naranjo algorithm. Statistical test applied was chi- square test.Results: 63 ADR were reported in Ofloxacin group and 19 ADR in Ciprofloxacin group. Insomnia was most frequent ADR (40%) in patients treated with Ofloxacin. There is high incidence of ADRs in ofloxacin group. chi square test showed this difference is statistically significant (p<0.05). Insomnia was significantly higher in ofloxacin group (p<0.05).Conclusions: In India frequently used and misused antimicrobials are fluoroquinolones. The present study concluded that no serious ADRs but ofloxacin group of patients have shown increased incidence of ADRs associated with CNS especially Insomnia. However, further large scale, multi-centric studies are needed to confirm these results.

Anti-fertility effect of flower extracts of Tabernaemontana divaricata in rats / 中国天然药物

AIM@#To evaluate the anti-fertility effect of methanolic (MeTD) and aqueous (AqTD) flower extracts of Tabernaemontana divaricata in rats.@*METHODS@#The anti-fertility activity of the extracts was evaluated using two experimental animal models: 1) Estrogenic activity was carried out in immature female rats using ethinyl estradiol as standard. The evaluation parameters includes changes in uterine weight and histopathology of uterus. 2) Anti-implantation and early abortifacient activity was performed in female Wistar rats. The number of implants and resorbtions were compared to vehicle control.@*RESULTS@#Phytochemical analysis of MeTD and AqTD revealed the presence of carbohydrates, amino acids, steroids, glycosides, flavonoids, alkaloids and tannins. In estrogenic activity, the MeTD and AqTD were offered significant estrogen-like activity at 500 mg·kg(-1), p.o. by increasing the uterine weight compared to vehicle control group. In Anti-implantation and early abortifacient activity study, MeTD (500 mg·kg(-1), p.o.) showed significant effect and it was evident by decrease in the number of implants and increase in the number of resorbtions compared to vehicle control group.@*CONCLUSION@#The MeTD at 500 mg·kg(-1), p.o. possess significant estrogenic, anti-implantation and early abortifacient activity, while the AqTD at 500 mg·kg(-1), p.o. was found to possess significant estrogenic activity and the results are in consistent with the literature reports related to anti-fertility effect of flower extracts of Tabernaemontana divaricata.

Effect of hydrophilic natural gums in formulation of oral-controlled release matrix tablets of propranolol hydrochloride

In order to develop a controlled delivery of highly water-soluble propranolol hydrochloride [PPHCl] using hydrophilic natural gums [xanthan gum [X] and locust bean gum [LBG]] as cost-effective, nontoxic, easily available. The granules of PPHCl were prepared by wet granulation method using a different ratios drug: gum ratios of X, LBG and XLBG[X and LBG in 1:1 ratios]. To increase the flowability and compressibility of the granules, and to prevent its adhesion to punch and die, magnesium stearate and talc were added to the granules in 1:2 ratios before punching. The tablets was analysed to determine hardness, friability,% assay and invitro release study was carried out. The release of PPHCl from a gelatinous swollen mass, which controls the diffusion of drug molecules through the polymeric material into aqueous medium. The XLBG matrices shows precise controlled release than the X and LBG matrices because of burst effect and fast release in case of X and LBG matrices respectively and there was no chemical interaction between drug and polymers in XLBG formulation as confirmed by FTIR studies. First pass effect of PPHCl can be avoided by these formulations. Matrices with XLBG show zero-order release via swelling, diffusion and relaxation mechanism. The XLBG matrices leads to more precise result than X and LBG alone by the utilization of synergistic interaction between two biopolymers and uniformity in the hydration layer in dissolution media. However, according to the similarity factor [f2] XLBG3 were the most similar formulation to Lol-SR as the reference standard