Drug utilization study of urinary tract infections in obstetrics and gynecology department

Background: The aim of study was to determine the utilization pattern of antimicrobial agents in obstetrics and gynaecology department. Antimicrobial agents are one of the most commonly used drugs word wide and has main contribution in human health system. UTI infection is one of the most widespread bacterial infections of genitourinary tract which can be treated by AMAs. The main aim of this study is; to identify the pattern of drug utilisation of antimicrobials in prescriptions, to analyse the utilisation of different classes of drugs and to identify the outcome of the treatment. Methods: This prospective, observational and analytical study was conducted in patients of obstetrics and gynaecology department of MMIMSR, Mullana after obtaining approval from institutional ethical committee. Demographic data, medical history, prescribed treatment details (drug name, dose, frequency, dosage form etc) and diagnosis, type of UTI, laboratory investigations and outcome of treatment was evaluated. Results: A total 242 female patients were registered, out of which 200 were included in the study as 42 were dropouts. Majority of female patients were belonging to the age group of 18-37 (63%). Most of the female patients had uncomplicated UTI 188 (94%) (p value=0.35), 186 (93%) had significant pyuria and 64 (32%) had urine culture positive (p value= 0.01). Burning micturation and frequency were the most common symptoms observed in 146 (73%). In the study 67(33.5%) females were pregnant and 133 (66.5%) were non pregnant (p value= 0.01). Out of 200 patients 64 (32%) had positive urine cultures and 136 (68%) had negative urine culture reports. E. coli 28 (14%) was the most common bacteria isolated followed by Klebsiella 16 (8%). Average number of drugs prescribed per prescription to non-pregnant was 3.97 and to pregnant were 4.67. In majority of prescriptions, the drugs were prescribed by oral routes (51%) and most of the drugs prescribed were generic (57%). Most of the patients (93%) were recovered from UTIs in 5-7 days of treatment. Conclusions: Our study concluded that the uses of AMAs for UTI were found to be rational and according to the causative organism and susceptibility pattern.

Correlation between prostate specific antigen and prostate volume with disease symptom severity assessed by international prostate symptom score

Background: Benign prostatic hyperplasia (BPH) is clinically defined as prostate adenoma, resulting in bladder outlet obstruction (BOO), which may eventually harm the bladder and even kidneys. For differential diagnosis of male LUTS, uroflowmetry can be used together with non-invasive ultrasound to ascertain the flow rate and IPP. PSA is also an important indicator for differential diagnosis. International prostate symptoms score (IPSS) is used to assess the severity of the symptoms for clinical BPH. There is also a recommendation to consider the quality of life (QoL) index, where a QoL score of ?3 is considered as worrisome. Methods: This was a retro-prospective study based on secondary and primary data collection and analysis, pertaining to BPH patients who visited the study site previously as well as those who are coming for regular follow-up since 2019. Patient enrolment was done at a teaching hospital Shree Krishna Hospital affiliated to the Pramukh Swami Medical College, Bhaikaka University, Karamsad. About 100 patients presenting with lower urinary tract symptoms (LUTS) and histo-pathologically proven cases of BPH were enrolled to pursue research objectives. All patients were followed up to a period of 3-months after initiating the treatment and disease severity through IPSS and quality of life upon completion of treatment were also assessed. Results: PSA is also an important indicator for differential diagnosis, which is generally less than 1 ?g/l in patients in absence of clinically confirmed BPH. In our study, mean prostate volume was reported to be 43.46±19.35 cc. A positive correlation was observed between prostate volume and serum PSA with disease severity. Conclusions: Our study evaluated the IPSS to predict the disease severity and correlated it with quality of life, prostate volume and serum PSA. Our findings were in line with currently available evidences, and suggested that QoL, prostate volume and serum PSA are better predictors of disease severity, IPSS.

Association of β2-adrenergic receptor and insulin receptor substrate-1 polymorphisms with obesity in a Northern Indian population.

BACKGROUND: Imbalance in hormonal levels, regulated by host genetic factors, are known to be a major cause of obesity. Therefore, we aimed to evaluate association of genetic polymorphisms of β2-adrenergic receptor (β2-AR) and insulin receptor substrate-1 (IRS-1) with hormonal levels in northern Indian obese. METHODS: A total of 111 obese and 89 age matched non-obese subjects were studied after taking detailed clinical profile. Hormonal assays in serum/plasma for different hormones were done using IRMA and RIA kits. Genetic analysis of β2-AR (-47 and -20, T to C) and IRS-1 (Arg972Gly) was done using PCR-RFLP. STATISTICAL ANALYSIS: Statistical analysis was performed by SPSS (version 11.5) software. All continuous variables were expressed as mean ± SD and tested by ANOVA test. Comparisons of categorical variables were assessed using X2 tests or Fisher's exact test. P-value <0.05 was considered as significant. RESULTS: Analysis showed that obese subjects had significantly higher value of blood pressure (systolic), WHR, leptin insulin and glucagon and lower value of GH. In β2-AR (-47) T/C and IRS-1 Gly972Arg gene polymorphisms we did not found significant differences in genotype or allele frequencies. Moreover, none of the studied hormonal or metabolic parameters showed any association with the gene polymorphisms. CONCLUSIONS: Study reveals no significant association of β2-AR (-47 and -20, T to C) and IRS-1 Gly 972 Arg polymorphisms with obesity in northern Indians.

"Effect of short-term cigarette smoking on insulin resistance and lipid profile in asymptomatic adults".

Present study examined the effect of short-term cigarette smoking on insulin resistance and lipid profile in asymptomatic healthy adults. This case control study comprised of 44 healthy male subjects in the age group of 18-40 yrs having BMI 25+3 and WHR < 1.0. Of these 22 smokers were included in the study group and 22 non-smokers in the control group. Subject selection was done such that one smoker and one non-smoker sibling or first degree male relative were selected from the same family. We compared fasting plasma glucose, insulin, lipid profile, and homeostatic model assessment index (HOMA Index) as a measure of insulin resistance between both the groups. Our observation showed that significantly higher values of serum glucose (133.36 +/- 23.45 mg/dl; P < 0.001), serum insulin (32.04 +/- 6.0 2 microU/ml; P < 0.001) and HOMA index (3.62 +/- 0.21; P < 0.001) were found in smokers as compared to non-smokers (serum glucose 86.95 +/- 19.32 mg/dl, insulin 20.09 +/- 4.8 microU/ml, HOMA index 3.29 +/- 0.30). No significant difference was observed for number of subjects having insulin resistance (HI > 3.8) and lipid profile in both the groups. Thus it appears that smokers are prone to develop hyperinsulenemia, hyperglycemia and the metabolic syndrome.

Knowledge of general public and health professionals about tetanus immunization.

OBJECTIVE: To study the awareness among general public and health care providers about tetanus immunization in relation to injuries, and their knowledge about tetanus immunization schedules in children, pregnant females and adults. METHODS: It was a cross-sectional study done at a perfect health mela and all the government allopathic health agencies in Delhi. RESULTS: The knowledge of tetanus immunization was poor among general public as well as health care providers. A substantial proportion of them indicated tetanus injection after every injury, which was unwarranted. The knowledge of tetanus immunization schedule for adults was poor among all categories of respondents, though it was comparatively better for pregnant females, but only 75% of doctors and 51.1% of nursing personnel correctly knew the immunization schedule against tetanus in children. CONCLUSION: There is a need to upgrade the level of knowledge among health care providers so as to ensure that schedules of tetanus are followed properly and unnecessary repeated immunizations are avoided and the same knowledge is passed on to the general public also.

An investigation into the JE epidemic of 2000 in Upper Assam--a perspective study.

The viral encephalitis epidemic during 2000 involved all the seven districts of Upper Assam (with 96.4% cases). The epidemiological, serological, clinical and entomological observations of the epidemic confirmed it to be due to JE. These were analysed, presented and discussed in the light of past history/records of the disease in the state. The epidemic was confined to the peak monsoon months of July and August (96% of the cases in the past). Serologically, 75-90% cases were confirmed to be due to JE. Case fatality Rate was 42.11% (overall average of the state in the past). There was no difference in case incidence among children or adults. Male to female ratio was 1:0.6. Based on the abundance and host preferences during the transmission period as well as virus isolation studies (as per past studies in the area) the main vectors Culex vishnui and Mansonia annulifera were susceptible to 4% DDT.