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Background: Congestive cardiac failure/congestive heart failure (CCF/CHF) is one of the major public health problem seen in more than 23 million people worldwide. Drug utilization studies were stood as a powerful exploratory tool to ascertain the role of drugs in determining the therapeutic efficacy, cost effectiveness and also in minimizing the adverse effects due to it during the treatment of a disease. Aims and Objectives: The present study undertaken to describe the drug utilization pattern in patients of CHF in a tertiary care hospital. Materials and Methods: This is a Prospective, Observational, and Non-interventional study. The study was undertaken after obtaining the ethical committee approval in the in-patient department of Medicine. Case records of 100 patients were obtained and treatments were noted. Results: The present study had 60 male and 40 female patients admitted and undergoing treatment for CCF. Most of them were above 50 years of age and the most common comorbidity among them were hypertension (25%) followed by diabetes mellitus (19%). The most commonly used drugs were diuretics and antihypertensives. Conclusion: In our study, patients use of more than 2 ?3 drugs (Polytherapy) was found very common than use of one drug (Monotherapy).
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COVID-19 has been labeled a serious public health emergency globally. Due to its high infectivity it has led to an increased burden to the Medical Fraternity as well as the Government. Therefore, the need for preparedness as well as conventional intervention strategies became integral during such health emergencies. To monitor the implementation of proper activities and to manage the patient load with adequate safety of the staff, COVID control rooms were established in the hospital premises. The main objective of the Control Room is risk mitigation, planning strategies, alleviating concerns and addressing issues associated with the health emergency across the hospital and further delegating the information to the higher authorities and the Ministry. Hereby in this review we have tried to summarize the administrative structure, functions and limitations of the 24x7 Control Room established in Tertiary Care Hospital, New Delhi.
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Background: Optimal infant and young child feeding practices (IYCF) are effective public health intervention to enhance child survival, nutrition and development. There is also documented evidence regarding the pro-tective effect of optimal IYCF practices against diarrhoea and ARTI. The objective is to assess knowledge and practices regarding IYCF among study participants & to explore the association of feeding practices of mothers with the morbidities (infections) in their children. Methodology: The present study was a hospital based cross-sectional study, carried out during September 2019 to March 2021. A total of 380 mothers of children less than two years attending OPD of Institute of child health, Nirmal hospital private limited, a tertiary care multi-specialty hospital was interviewed using pre-designed and pretested questionnaire. Results: Feeding practices during early days of life to be reasonably good among study participants with al-most 2/3rd of the study participants practicing them. Mean number of morbidity episodes requiring consulta-tion were significantly lower in the children whose mothers practiced optimal IYCF practices. Conclusion: Poor feeding practices in children had significant association with morbidity episodes of diar-rhoea and ARTI in children.
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BACKGROUND: Practicing hand hygiene is a simple yet effective way to prevent Health Care Related Infections. The objectives of the study were to study the knowledge and attitude regarding hand hygiene among nursing staff and study the availability of hand-hygiene facilities in a tertiary care hospital. A METHODS: cross-sectional study was conducted and a total of 100 study participants were selected by simple random sampling. Knowledge and attitude of the nurses were captured by interviewing the nurses and recording the data on pre-tested questionnaire. The results were compiled on Windows Excel spreadsheet and summarized by calculating proportions and percentages. Chi-square test was applied to identify association between knowledge and attitude regarding hand-hygiene and likely determinants. It was found that there was significant positive association between knowledge and attitude of nursing staff and formal training received during previous one year regarding hand hygiene.
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Introduction :Birth weight is one of the most important criteria for determining neonatal and infant survival and is considered a sensitive index of the nation's health and development. The World Health Organization (WHO) defines low birth weight (LBW) as “Birth weight less than 2500 grams” regardless of gestational age, the measurement being taken preferably within the first hour of life. 1)ToObjectives : estimate the prevalence of LBW among sample population at tertiary care hospital. 2)To study the distribution of newborns, according to socio-demographic characteristics of the mother and its association with LBW. A hospital based cross-sectional study was carried out among 500 newborns betweenMethod: December 2020 and November 2021. Participants were selected by systematic random sampling technique. The data were collected from the case file and face-to-face interview. Both descriptive and inferential statistics were used in the analysis. Prevalence of low birth weight was 29.2%. Majority 271Results: (54.2%) of newborn mothers' age group was between 21 to 25 years. More than half 272 (54.4%) newborns were from mothers who studied up to primary level education and more than three forth 389 (77.8%) were from mothers who were housewives. Majority 293 (58.6%) of newborns were from the urban area, around three forth 382 (76.4%) newborns were Hindu and nearly two fifth 194 (38.8%) newborns belonged to lower middle class. Prevalence of low birth weight was significantly higher in mothers aged >35 andyears ?20 , who were illiterate, doing labour work and belonging to lower socio-economic class.years Conclusion: The prevalence of Low Birth Weight was 29.2% among sample population. Socio-demographic variables like maternal age >35 years 20 years, illiteracy, labour work and lower socio-economic class, ? had shown significant risk for delivering Low Birth Weight babies.
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Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a contagious viral pathogen, creating a public health emergency, and affecting lives and livelihood of millions of populations globally. Good knowledge, attitude, and practice are essential to prevent and stop the widespread transmission. Aims and Objectives: The aim of the study was to assess the knowledge, attitude, and practices regarding COVID-19 among health-care workers (HCWs) in tertiary care hospitals of Odisha. Materials and Methods: The present study is an observational, cross-sectional, and question-based online research. Questions were created on Google forms. Link was generated and given through social media apps. The questionnaire consists of four sections. First section comprised demographic characteristics. Second, third, and fourth sections contain questions on knowledge, attitude, and practice related to COVID-19, respectively. Descriptive and inferential statistical procedures were done through IBM SPSS statistics version 24.0. The research was granted approval by Institute Ethics Committee of IMS and SUM Hospital. Results: Data were analyzed in 430 subjects, 205 females and 225 males. The majority of HCWs have good knowledge score 86.5%, attitude score 80.9%, and practice score 91.2%. The mean knowledge score was 6.6 ± 0.84 and mean attitude score was 28.5 ± 1.89. Knowledge and attitude score was found to be significantly different among age groups and gender, p<0.001. Mean attitude score had a significant difference with working status, P = 0.025. Mean knowledge and attitude score was significantly higher across professions and work experience, P < 0.001. Good practice score varies significantly across professions, P < 0.001. Conclusions: The most of HCWs had good knowledge, positive attitude, and adopted appropriate practices regarding COVID-19. Periodic educational interventions are strongly recommended for HCWs to upgrade their knowledge, attitude, and practices regarding coronavirus diseases.
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Background: In India, most individuals with an intellectual disability live with their families. The present study examines the perceived burden of family members, treatment expectations, and awareness of disability benefits for adult individuals with Intellectual Disability (ID). Methodology: A sample of 50 individuals registered in an Adult Psychiatry Unit was referred for intelligence assessment. The assessment was done using standardized psychological tests. Data was gathered using a semi-structured interview schedule during counselling the participants’ family members. Data obtained was examined using descriptive statistics. Results: Average age of participants was 27.5 years, and the majority 64%, were male patients. Comorbid conditions such as seizure disorder, psychosis and obsessive-compulsive disorder (OCD) were present in 46 % of the sample. Caregivers were primarily parents, and a higher level of family burden was due to behavioural problems. Half (50 %) of the sample was unaware of disability benefits. Conclusion: Findings indicate the need to address caregiver burden and plan psychosocial rehabilitation and improve awareness about disability benefits and its implications more consistently across India.
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Background: Security guards/protective inspectors are a group of professional gray collar workers responsible for safety and security of general public. In healthcare institutions, they play a pivotal role in streamlining the movement of patients, healthcare workers as well as other people as well as keeping a check upon the law-breaking activities within the premises. These professionals are constantly overburdened with responsibility and many of them are under the verge of physical, mental, and emotional crisis leading to various health issues. Aim and Objective: To assess the influence of changing work patterns on the overall physical health of security guards working in the hospital. Materials and Methods: A cross-sectional study was carried out in a tertiary care hospital in the Eastern part of Odisha involving all the security personnel currently working. Universal sampling was opted and 465 personnel participated in this study. Results: Of the total, 213 (45.8%) were between 30 and 40 years of age and 398 (85.5%) were male. 179 (38.4%) were overweight and 52.2% had a waist-hip ratio above normal range for their gender. Prevalence of anemia and Conjunctival xerosis was significantly higher among night shift workers with P < 0.001 whereas hypertension (P = 0.08) and rheumatoid arthritis (P = 0.006) was significantly higher among morning shift workers. Conclusion: Being a distinctive member of the hospital, it is high time that regular health check-ups and social security measures should be made available to them in order to provide quality life which will in turn ensure better hospital safety and security.
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Abstract Background: Respiratory distress syndrome (RDS) is Mexico's second leading cause of neonatal mortality. The 75% reduction in mortality due to RDS has been attributed to the use of nasal continuous positive airway pressure (nCPAP). A survey was conducted to determine the perception of the medical staff regarding the availability of nCPAP equipment and supplies in Mexican hospitals with neonatal intensive care units (NICUs). Methods: We sent a survey via e-mail to several neonatologists in each state of the country, requesting only one response per hospital. We performed statistical analysis with SPSS software. Results: We received 195 surveys from private (HPri) and public (HPub) hospitals with NICUs nationwide: 100% of HPri and 39% of HPub. More than 75% of the nursing and medical staff had received formal training in nCPAP in 11% of HPri and 5% of HPub. The perceived availability of CPAP equipment was 83.7% vs. 52.1%; nasal cannula supply, 75.5% vs. 36.3%; air/oxygen blender availability, 51.0% vs. 32.9%, in HPri and HPub, respectively. The observed differences were statistically significant. Significant differences were also found among healthcare institutions. Conclusions: The availability of CPAP equipment and consumables between HPub and HPri is unbalanced and is lower in public institutions. Bubble CPAP is not included essential equipment in the national catalog of instruments and equipment for public hospitals, and its request is complicated. The training of CPAP staff and the availability of bubble CPAP and supplies in public hospitals should be improved.
Resumen Introducción: El síndrome de dificultad respiratoria (SDR) es la segunda causa de mortalidad neonatal en México. La reducción del 75% de la mortalidad por SDR se le ha atribuido al uso de la presión positiva nasal continua de las vías respiratorias (nCPAP). Se realizó una encuesta con el objetivo de conocer la percepción del personal médico acerca de la disponibilidad del equipo e insumos para nCPAP en hospitales de México que cuenten con unidades de cuidados intensivos neonatales (UCIN). Métodos: La encuesta se envió por correo electrónico a varios neonatólogos de cada estado del país y se solicitó una sola respuesta por cada hospital. El análisis estadístico se realizó con el software SPSS. Resultados: Se recibieron 195 encuestas respondidas tanto de hospitales privados (HPri) como públicos (HPub) que cuentan con UCIN a escala nacional: el 100% de HPri y el 39% de HPub. Más del 75% del personal de enfermería y médico recibió una capacitación formal en nCPAP en el 11% de HPri y el 5% de HPub. La percepción de disponibilidad de equipos de presión positiva continua de las vías respiratorias (CPAP) fue del 83.7% vs. el 52.1%; el abasto de cánulas nasales, del 75.5% vs. el 36.3%; la disponibilidad del mezclador aire/oxígeno, del 51.0 % vs. el 32.9%, en HPri y HPub, respectivamente. Las diferencias fueron estadísticamente significativas. También se encontraron diferencias significativas entre las instituciones de salud. Conclusiones: La disponibilidad de equipo y material de consumo para CPAP entre HPub y HPri es desequilibrada, y es menor en las instituciones públicas. El CPAP burbuja no se encuentra incluido en el cuadro básico de equipo médico y se dificulta su solicitud. Debe mejorarse la capacitación del personal en CPAP y la disponibilidad de CPAP burbuja e insumos en los hospitales públicos.
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Background: Diabetes is accompanied by a distinct decreased in subject抯 quality of life (QOL) and it shows to elevated disability-adjusted life years than most diseases. Depression shows the degrade QOL and is associated with wretched treatment outcomes and lesser the glycaemic control in diabetes. Objective of this study is to study the association between Quality of Life (QoL) and depression among type2 diabetes mellitus in Andhra Pradesh. Methodology: The present study is a case control study. There were 300 participants including 150 type2 diabetes mellitus patients, & 150 healthy individuals (age and gender matched) were also selected as a control to meet the purpose of the study. Subjects age range was set between 35-65 years. Beck depression inventory (BDI-II) and WHO quality of life scale (QOL BREF) were used for data collection, SPSS-26(v). Results: The study findings showed that significant but negative relation between depression scores and quality of life. 65% have Poor Quality of life & 57% have high depression in Diabetes Patients. 54% have good Quality of life & 78% have Mild Depression in Healthy Individuals. Conclusion: It is concluded that association between depression and sub-scales of quality of life indicating that high depression scores may lead to lower physical and psychological health impacting social relationship and environmental health.
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This retrospective, observational study was conducted by collecting data from medical records during COVID 19 pandemic from March 2020 till August 2020. This was compared with the data of 2019 during similar months. The impact of COVID 19 on use of preventive and curative paediatric health care service units like outpatient department, casualty, intensive care and immunization clinic were assessed. Data from 2019 to 2020 were compared using standard parametric and nonparametric tests. There was a significant decline in routine OPD (68%) attendance during the COVID 19 period as compared to pre-COVID period. Paediatric ward admissions and PICU admissions were decreased by 55% and 42% respectively. We also observed a significant 43% decline in the number of children attending immunization clinic in the year 2020. The fear of COVID 19 pandemic and the measures taken to control the pandemic has affected the health seeking behaviour of patients. This evaluation of trends in healthcare use may help in planning the delivery of healthcare service delivery in future.
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Resumen Introducción: COVID-19, causada por el betacoronavirus SARS-CoV-2, ha saturado los sistemas de salud del mundo. Objetivo: Describir las características epidemiológicas de los pacientes atendidos en un hospital de tercer nivel. Métodos: Se realizó una cohorte retrospectiva de pacientes con diagnóstico o sospecha de COVID-19, del 23 de marzo al 31 de julio de 2020. Resultados: En el Hospital Central Militar se hospitalizaron 4401 pacientes, 35 % derechohabientes, 26 % civiles, 28 % militares en activo y solo 11 %, militares retirados. Predominó el sexo masculino, tanto en los pacientes hospitalizados como en los que fallecieron, el grupo O+ y la ausencia de comorbilidades; entre las comorbilidades que se observaron, las principales fueron el sobrepeso y la diabetes. La mediana de edad de los pacientes hospitalizados fue de 49 años, mientras que 62 años fue la edad de quienes fallecieron; las mujeres mayores de 51 años tuvieron mayor riesgo de fallecer. La tasa de letalidad ajustada fue de 18.5 %; 50 % falleció durante los primeros seis días. Conclusiones: En este estudio se lograron identificar las características epidemiológicas y se destacaron las principales comorbilidades en pacientes mexicanos con infección por SARS-CoV-2.
Abstract Introduction: COVID-19, caused by the betacoronavirus SARS-CoV-2, has overwhelmed the world's health systems. Objective: To describe the epidemiological characteristics of patients treated in a tertiary care hospital. Methods: A retrospective cohort study of patients diagnosed with or suspected of having COVID-19 from March 23 to July 31, 2020 was conducted. Results: 4,401 patients were hospitalized at the Central Military Hospital, out of which 35 % were beneficiaries, 26 % civilians, 28 % active military, and only 11%, retired military. Male gender predominated, both in hospitalized patients and in those who died, as well as the O+ group and absence of comorbidities; among the observed comorbidities, the main ones were overweight and diabetes. Hospitalized patients' median age was 49 years, while median age of those who died was 62 years; women older than 51 years had a higher risk of dying. Adjusted case fatality rate was 18.5 %; 50 % died within the first six days. Conclusions: In this study, the epidemiological characteristics and main comorbidities in Mexican patients with SARS-CoV-2 infection were identified.
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Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Diabetes Mellitus/epidemiology , Overweight/epidemiology , COVID-19/epidemiology , Hospitalization/statistics & numerical data , Sex Factors , Retrospective Studies , Risk Factors , Cohort Studies , Age Factors , Tertiary Care Centers , COVID-19/mortality , Mexico/epidemiologyABSTRACT
Background: Febrile seizure is an event in infancy or childhood, usually occurring between 3 months and 5 years of age associated with fever but without evidence of intracranial infection. The aim of the study was to estimate the usefulness of neutrophil-to-lymphocyte ratio (NLR) in patients with simple and complex febrile seizures.Methods: Retrospective case control'' study was done in a paediatric in patients admitted to tertiary care hospital.' Study period'' was from January 2017 to December 2019. 200 children were analysed in the study. 100 out of 200 were under control group (febrile children without seizure). Remaining 100 were under case group (children with febrile seizure), 54 out of 100 children had'' complex febrile seizure, 46 out of 100 had simple febrile seizure. NLR ratio was done in all children.Results: Total 200 children were analysed in this study.'' High NLR ratio'' was noted among the cases (87 out of 100) compared to control (30 out of 100) p value = <0.001. Among the cases CFS had high NLR ratio compared to SFS, however p value was not significant (0.072).Conclusions: Children with febrile seizure had high NLR ratio compared to those without seizures. However no significant difference was noted between those with simple febrile seizure and complex febrile seizure'' However, larger trials are required'' to assess whether higher NLR can be taken as an independent risk factor for febrile seizure.
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Background: The prevalence of depression and anxiety in diabetes is considerably higher than normal population and found to have a negative impact on diabetes. Objective of the study was to assess the prevalence of depression and anxiety and to identify their associated risk factors among people with type 2 diabetes mellitus.Methods: Descriptive study was done in Endocrine and medicine outpatient Department of Vijaya Hospital in Belagavi, South India. Total 384 patients with type 2 diabetes mellitus were interviewed for depression and anxiety by administering the Hospital Anxiety and Depression Scale (HADS).Results: Of the total 384 patients surveyed, depression and anxiety were found in 32.56%. (95%CI 27.8-37.2%) and 37.76% (95% CI 33.1-42.9%) respectively. In Multiple Logistic regression analysis age, unmarried, religion, duration of type II diabetes and type of treatment were significantly associated with depression symptoms, Anxiety symptoms were associated with age, Qualification, Occupation, Religion, Duration and type of treatment.Conclusions: This study found a high prevalence of depression and anxiety in patients with Type 2 DM. Therefore, the care of individuals with type 2 Diabetes Mellitus (DM) should include the screening and possible treatment of depression and anxiety in order to achieve and sustain treatment goals.
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Coronary artery disease (CAD) is the leading cause of mortality in men and women. Acute coronary syndrome (ACS), is a major reason for hospitalisation in our country. Dyslipidemia has been identified as one of the most important modifiable risk factors for CAD. The aim of the study was to determine the prevalence and pattern of dyslipidaemia and its relation to other modifiable risk factors.METHODS100 cases were studied in a Krishna Institutes of Medical Sciences, Karad, over a period of 12 months from 1st August 2015 to 31st July 2016. This is a prospective observational study. All adults >18 years of age admitted for acute coronary syndrome were eligible for this study. The ACS group was studied as STEMI, NSTEMI, and Unstable Angina.RESULTSMajority of patients (33) was in the age group 51-60 years followed by 29 patients in the age group 61-70 years. Out of 100 ACS patients, 62 were STEMI, 20 were NSTEMI, and 18 were unstable angina. The prevalence of ACS was higher in males than females. Hypertension is the most common risk factor of ACS (41%) followed by diabetes mellitus (33%). We found that high levels of TC (more than 200 mg/dl) were found in 31% patients [mean ± SD (167.79 mg/dl ± 45.28)]. High levels of LDL (more than 130 mg/dl) were found in 23% patients [mean ± SD (97.47 mg/dl ± 38.24)]. Low levels of HDL (less than 40 mg/dl) were found in 52% patients [mean ± SD (40.69 mg/dl ± 11.84)]. High levels of TG (more than 150 mg/dl) were found in 37 % patients [mean ± SD (145.28 mg/dl ± 65.78)].CONCLUSIONSDyslipidemia is one of the major risk factors which is widely prevalent in patients with ACS and is more prevalent in males than in females. We recommend paying more attention to serum lipids and other modifiable risk factors for prevention of ACS
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Background: Improving maternal health is one of the eight-millennium development goals (MDGs). Since 1990, maternal deaths worldwide have dropped by 47%. This study aimed to determine the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic at a tertiary care hospital in Gujarat and their association with various sociodemographic factors.Methods: A cross-sectional study was carried out among 384 pregnant women in their 3rd trimester attending the antenatal clinic in a tertiary care hospital of Gujarat during April 2018 to September 2018. Pretested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed using SPSS version 20 and Epi Info software.Results: Study reveals that about 58% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, education, occupation, parity, type of family, and socioeconomic status (SES) had a significant association with awareness about ANC. 100% women were having a positive attitude toward ANC. Around 70%, women were practicing adequately, and variables such as education and SES had a significant association with practices about ANC.Conclusions: These findings can be used to plan a health intervention program aiming to improve the maternal health practices and eventually improve the health status of the women.
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PURPOSE@#Road traffic accidents (RTAs) are a public health issue and cost a lot to individuals, families, communities and nations. Trauma care systems in India are at a nascent stage of development. There is gross disparity between trauma services available in various parts of the country. Rural area in India has inefficient services for trauma care, due to the varied topography, financial constraints, and lack of appropriate health infrastructure. The present study is to study the trends of occurrence of RTA cases by month, week and time of accident occurrence as well as to research the types of vehicle involved in accidents and other various risk factors related to them.@*METHODS@#During 1st January 2017 to 31st December 2017, a hospital-based and cross-sectional study of RTA victims was conducted. The patients were admitted in emergency department of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, when stabilized, they were shifted to the orthopaedics and surgery ward.@*RESULTS@#In the study, 654 road accident victims were included, of which the majority were males (77.5%) and the most of them belonged to rural (67%). RTA victims according to the month of occurrence majority were found in January (12.5%) and evening was time of a day with maximum accidents (32.1%). Mortality cases of RTA victims based on type of road user and it shows decreasing trend of mortality of motorcyclists (54.2%) followed by pedestrian (25.1%).@*CONCLUSION@#There should be control over people driving vehicles under the influence of alcohol and drivers over-speeding and rash driving on urban roads as well as rural village roads.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Accidental Injuries , Epidemiology , Mortality , Accidents, Traffic , Automobile Driving , Cross-Sectional Studies , Emergency Service, Hospital , Risk Factors , Seasons , Tertiary Care Centers , TimeABSTRACT
Introduction: Despite the advancement in medicine,management of heart failure (HF), which usually presentsas a disease syndrome, has been a challenge to healthcareproviders. The study was commenced with objective tostudy the profile of patients presented with heart failure withreduced left ventricular ejection fraction (LVEF) in a tertiarycare hospital.Material and Methods: It was a cross sectional hospitalbased study. Both male and female patients presented withheart failure with reduced ejection fraction (HFrEF) treated indepartment of General Medicine, GITAM Institute of MedicalSciences & Research were included based on inclusion andexclusion criteria. A total of 100 consecutive patients werestudied during February to October 2019. After obtainingapproval from Institutional Ethics Committee and informedconsent taken from all study participants data was collected.Data entered in MS excel sheet and analyzed by using SPSSsoftware.Results: Among total 100 heart failure patients males were69, females were 31. The mean age of study population was56.61±13.01 years. All patients presented with shortness ofbreath of varying degree of New York Heart Association(NYHA) class. The common risk factors observed werehypertension (53%), diabetes (36%), alcohol (14%), smoking(40%). The common causes for heart failure found wereIschemic heart disease (64%), followed by non-ischemicdilated cardiomyopathy (21%) and rheumatic heart disease(15%). Majority of the study participants were receivingtreatment with diuretics (66%), statins (65%), followed bybeta blockers (25%), aldosterone antagonist (25%), ACEinhibitors (30%).Conclusions: Early detection and optimal treatment ofcommon risk factors might play role in preventing Heartfailure and thereby reducing disease burden in the country
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Rational use of corticosteroids is very essential for improving patient safety on long term use. The present study aimed to study the prescribing usage pattern of corticosteroids in a tertiary care hospital. A prospective observational study was conducted in the department of dermatology, gynecology and general medicine in a tertiary care teaching hospital for the period of 6 months (August-February). All patients receiving any category of Steroid therapy were included and the prescribing and tapering pattern of steroids were reviewed. Prescribing pattern was observed and analysed in 132 participants during the study period. Cases were collected from the departments of Dermatology, General Medicine, Pediatrics and Gynecology in Gandhi Hospital, Secunderabad. All the prescriptions containing steroids were included in this study and the parameters evaluated were gender distribution, age of the patients, types of steroids according to the route of administration, number of prescribed daily dose (PDD) where compared with defined daily dose (DDD). In the collected 132 cases, 162 times corticosteroids were prescribed. The steroid utilization was found to be more in female patients, the maximum number of cases with corticosteroids was found in Dermatology department (39.4%). Particularly Injection Dexamethasone (24.7%) and Tablet Prednisolone (24.7%) are mostly prescribed. Most drugs were prescribed rationally although some factors like improper history, drug administration time and tapering were deviating away from rationality. Although most of the drugs were prescribed rationally, involvement of a Clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.
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Background: Musculoskeletal trauma represents a considerable global health burden. Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. So the purpose of the study was to do assessment of pain management intervention, post-op analgesics for treatment of long bone fractures.Methods: All adult patients (more than IS years) reporting to Emergency Medicine Department of a tertiary care hospital with long hone fractures of lower limb were included in the study. Patient pain management was assessed by visual analogue score (VAS). Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. The entire data is statistically analyzed using SPSS software. p-values less than 0.05 are considered to be statistically significant.Results: 74 cases got operated, 64 cases (86.5.0%) did not have any intra-op complications and 10 cases (13.50%) had intra-op complications .Postoperative analgesia the 74 cases operated was as follows: 17 cases (23.0%) epidural anaesthesia 41 Cases (55.4%) had epidural + intravenous analgesics. Recent was managed with 1.V, analgesics alone; 12 cases (16.20%) had tramadol, 2 cases (2.7%) received paracetamol and 2 cases (2.7%) had dynaper for post-operative analgesia.Conclusion: Adequate pain management on arrival in the Emergency Department is an important aspect in patient care and is not at all difficult to achieve. Femoral nerve block in Proximal lower limb fractures is very effective and easy to perform.