Abundance of Major Insect Pests in Rice and Their Relation to Weather Parameters

The present investigation has been conducted in rice crop during Kharif 2021-22at Students’ Instructional Farm of Acharya Narendra Deva University of Agriculture and Technology, Kumarganj, Ayodhya (U.P.), India. The population of six major insect pests was recorded viz. Rice Yellow stem borer (Scirpophaga incertulus), Rice Leaf folder (Cnapholocrocis medinalis), Rice ear head bug (Leptocorisa acuta), Brown plant hopper (Nilaparvata lugens), White backed plant hopper (Sogatella furcifera)and Green leaf hopper (Nephotettix nigropictus) that cause most damage at different crop growth stages initiated after sowing till harvesting. The maximum population of yellow stemborer was observed on rice crop at 36th SMW (12.20 per cent dead heart). The infestation of dead heart was non-significant positively correlated with minimum, maximum temperature and RH% (0.433, 0.010 & 0.253 respectively) and negatively correlated with rain fall (0.081) whereas, significant negatively correlated with sunshine (0.552*). The maximum population white ear in 40th SMW (16.80 per cent). The infestation of white ear was non-significant negative correlation with minimum, maximum temperature (-0.062, -0.167) and positive correlation with RH & rain fall (0.244 & 0.173) whereas, significant positive correlation with sunshine (0.703*). Maximum leaf folder population was observed during 35th SMW (16.35 per cent). and infestation of leaf folder was non-significant positive correlation with minimum temperature & RH (0.427 & 0.505) and negative correlation with maximum temperature, rainfall and sunshine (-0.079, -0.030 & -0.291). The maximum population was recorded of ear head bug in 38th SMW i.e., (10.90 ear head bug/hill respectively.). The infestation of ear head bug was non-significant positive correlation with minimum temperature, RH, rainfall & sunshine (0.061, 0.176, 0.155 & 0.210) and negative correlation with maximum temperature (-0.407). The peak mean population of BPH was recorded in 37th SMW i.e., (11.25 brown plant hopper/hill respectively.) Itwas non-significant positive correlation with minimum temperature & RH (0.463 & 0.357) and negative correlation with maximum temperature & rainfall (-0.066 & -0.088) whereas, significant negative correlation with sunshine (-0.597*), The peak mean population of WBPH was recorded in 38th SMW i.e., (12.80 white backed plant hopper/hill respectively.) It was non-significant positive correlation with minimum temperature, RH & rainfall (0.300, 0.337 & 0.185) and negative correlation with maximum temperature (-0.300) whereas, significant negative correlation with sunshine (-0.094*) and the maximum population of green leaf hopper was recorded in 37th SMW i.e., (10.80 green leaf hopper/hill respectively.) with the infestation of green leaf hopperwas non-significant positive correlation with minimum temperature & RH (0.479 & 0.369) and negative correlation with maximum temperature & rainfall (-0.077 & -0.120) whereas, significant negative correlation with sunshine (-0.633*).

Comparison of electrocardiogram diagnostic criteria in diagnosis of left ventricular hypertrophy using 3D echocardiography as standard

Background: The echocardiogram (ECHO) has a better diagnostic performance for left ventricular hypertrophy (LVH) than the electrocardiogram (ECG), but ECG is most widely used diagnostic method. We aimed to assess the correlation between ECG based diagnosis of LVH with echocardiography-based diagnosis of LVH as standard. Methods: Patients with evidence of LVH using echocardiographic criteria were included in the study. Patients were subjected to four electrocardiographic criteria to assess the LVH: 1. Sokolow-Lyon criteria; 2. Romhilt and Estes scoring system; 3. Cornell voltage criteria; and 4. Gubner voltage criteria. After assessing the results of ECG and echocardiography diagnostic validity tests (by calculating specificity and sensitivity), the Kappa measure of agreement was performed. Results: In maximum patients (52.8%) LVH was detected by using ECG LVH Sokolow Lyon criteria, followed by Cornell voltage CR criteria that detected LVH in 38.9% cases. Sokolow Lyon ECG criteria showed high sensitivity while Romhilt and Estes criteria showed maximum 98% specificity in diagnosing LVH. Sokolow Lyon’s ECG criteria was highly sensitive in assessing all co-morbidities, except CKD where it was diagnosed better by using Cornell voltage criteria. Conclusions: In cases of diagnosing LVH in patients with co-morbidities, ECG LVH Sokolow Lyon CR was found to be the most sensitive criteria except CKD where it was diagnosed better by using Cornell voltage criteria. For assessing the patients for LVH, the role of ECG with all the commonly used criteria is of limited value and ECHO should be the method of choice.

A Prospective, Interventional, Multicentre, Post-marketing Clinical Study of a fixed-dose combination of Paracetamol (125 mg), Phenylephrine HCL (5 mg), Chlorpheniramine Maleate (1 mg) and Sodium Citrate (60 mg/5 mL) for the Treatment of Common Cold and Flu Syndrome in Children

Background : Common cold is an acute, self-limiting viral infection of the upper respiratory tract involving the nose, sinuses, pharynx, and larynx. According to various studies, the combination of analgesics, decongestants, and antihistamines provides better relief for multiple symptoms in the common cold. Fixed dose combination of Paracetamol as an analgesic, anti-inflammatory, and antipyretic, Chlorpheniramine maleate, an anti-histaminic, and Phenylephrine as a nasal decongestant is primarily used in the treatment of the common cold. Hence the present post-marketing surveillance study was planned to find any unwanted adverse effects and efficacy of commercially available combination in treating the common cold in children. Methodology : The prospective, single-arm, multicenter, post-marketing clinical study included 224 children from four different study sites, of which 204 completed the study. Subjects were given this fixed dose combination for three days and then monitored for the next six days. During the study, the efficacy was evaluated using VAS score changes from the beginning to the end of the treatment. Incidence of Adverse Events (AE) and Serious Adverse Events (SAE) was assessed. The product's safety was also evaluated using blood biomarkers such as Hemoglobin, Platelet count, SGOT, SGPT, and creatinine level. Results : The reduction in symptomatic score of common cold and flu syndrome was observed after 3rd followup visit [(0.384±0.168 (visit 1) to 0.001±0.009 (Visit 3), (p<0.001)]. No intervention-related or serious adverse events (SAE) were observed in the study or follow-up period. The study found no major changes in the levels of haemoglobin, platelets, SGOT, SGPT, and creatinine. Conclusions : Fixed-dose combination of Paracetamol (125 mg), Phenylephrine HCL (5 mg), Chlorpheniramine Maleate (1 mg) and Sodium Citrate (60 mg/5 mL) is safe and effective in treating children's common cold and flu syndrome.

Management of Gastric Ulcer w.s.r. Annadrava Shool in Ayurveda: A Case Study

Annadrava shoola is one of the diseases of the alimentary canal in which there is colic occurs after digestion, during digestion or at any time and Patient feels relief after vomiting. It can be said gastric ulcer on the basis of its signs and symptoms. Gastric ulcers are most commonly located on the lesser curvature, whereas duodenal ulcers are most common at the duodenal bulb. The ulcer is round to oval with a smooth base. Acute ulcers have regular borders, while chronic ulcers have elevated borders with inflammation. An ulcer extends beyond the muscularis mucosa. Ayurveda encourages lifestyle interventions and natural therapies to regain a balance between the body, mind and the environment. In this paper, a case study on Annadrava shoola has been explained. A female patient of 42 years of age came to the Kayachikitsa OPD (OPD REG.no-6836) Government Ayurvedic College and Hospital, Patna-03 having complain of pain and burning sensation in abdomen for 5 months as well as irregular bowel evacuation (>3episode) in the last 3 months. The nature of pain was gradual on onset and burning type and exaggerated after meal. On the basis of history of the patient and endoscopy report, he was diagnosed as gastric ulcer and pan gastritis. We have done the Shamana Chikitsa for the patient. In Shamana Chikitsa was done with combinations of Sutashekhar Ras, Tab Aciloss and Shatavari Churna for one month. Endoscopy was repeated after one and half months of treatment. Report showed only that the treatment cured the Annadrava shoola (gastric ulcer) of the patient. So, there is hope in Ayurveda for the treatment of Annadrava shoola.

Ayurvedic Management of Ulcerative Colitis: A Case Study

Ulcerative colitis is a chronic inflammatory condition in which patients show altered bowel habit such as diarrhoea, constipation, rectal bleeding, tenesmus, passage of mucous and crampy abdominal pain etc. These symptoms may be relapsing and remitting episodes of inflammation limited to the muscles layer of colon. Allopathic medicine definitely made the life comfortable for human beings with various research and advancement in treatment modalities but in certain disease like ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, inflammatory bowel disease and many more diseases it also searches a search engine and probably Ayurveda play this role in several ways. In Ayurveda Raktaja Arsh, Raktatisara, Raktaja Pravahika, Grahani shows symptoms having resemblance with Ulcerative colitis. Ayurveda described various treatment modalities for the management of Ulcerative colitis such as Anuvasan Basti, Piccha Basti, Samshamanyogas, proper nutritional supplements, herbal therapy, Yoga and meditation etc. In present study, A diagnosed case of ulcerative colitis, age 61yrs male from Dhanbad, Jharkhand came to OPD of Kayachikitsa, Government Ayurvedic College and Hospital, Patna. He complained of pain in abdomen, bleeding per rectum, excessive thirst, pain in joints of lower limb bilaterally. He was given Anuvasan Basti and Piccha Basti along with some drugs and his complaints not only relieved delayed remission as well. The goals of the treatment are to improve quality of life, minimize the risk of colon cancer and achieve steroids free remission of the disease ulcerative colitis.

A Case Study: Management of Ankylosing Spondylitis in Ayurveda

Ankylosing spondylitis (AS) is chronic inflammatory disorders of unknown cause that primarily affects the axial skeleton (Predominantly sacroiliac joints and spine) peripheral joints and of extra articular structures may also be involved in an asymmetrical pattern. The disease usually begins in the second or third decade; the male to female prevalence is approximately 3:1. Patients having AS, more than 95% of them are positive HLA-B27. Use of NSAIDS are the first line of management and they effectively relieve the symptoms. Few Ayurvedic medicines found to be effective in the management of AS. Here, a case study of AS managed by Ayurvedic treatment approaches is presented. A patient 21yrs male came to OPD of Kayachikitsa i.e., Room No. 9 of GACH, Patna. He complaint of pain in B/L ankle left>right, also B/L knee joint pain as well as low back pain for 6 months. He was diagnosed on the basis of its signs and symptoms of AS with HLAB27 positive. He was managed by Ayurvedic medicines like Panchatikta Ghruta Gugglu, Ekangveer ras, Tab. Shallaki, Cap. Stresscom, Jrumax oil, Vaishwanar churna, Laxarid for 7 months and relief in his signs and symptoms.

Bacterial Colonization of Home Nebulizers Used by Children With Recurrent Wheeze

Objective: To look for bacterial colonization of parts of home nebulizers used for children with recurrent wheeze and asthma. Methods: Children aged 1 mo-12 y, using home nebulizers for recurrent cough and wheeze were enrolled from May to October, 2019. Caregivers were administered a structured questionnaire by a single researcher, during their hospital visit, to elicit information on their nebulizer cleaning practices. Samples were taken from nebulizer medicine chamber and tubing for bacterial culture and sensitivity. Results: Bacterial growth was observed in 17 culture samples obtained from medicine chamber and/or tubing of nebulizers used by 12 (20.3%) out of the 59 enrolled children. The bacteria isolated were Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus (Methicillin resistant S. aureus and Coagulase negative staphylococci) and these were resistant to many of the commonly used antimicrobials. Almost 20% parents had never cleaned the nebulizers. Diluent re-use was significantly associated with bacterial colonization of nebulizer parts [AOR (95% CI) 20.6 (2.26-188.5); P=0.007]. Conclusion: Home nebulizers, if not cleaned properly as per set protocols, may get colonized with potentially harmful bacteria. There is a need to increase awareness about their proper use amongst parents of children with recurrent wheeze.

Safety & Efficacy of a Fixed Dose Combination of Paracetamol (125 mg), Phenylephrine (2.5 mg) and Chlorpheniramine Maleate (1mg) [Flucold Drops] in the Treatment of Common Cold and Flu Syndrome in Children : Postmarketing Surveillance Study

Background :The common cold and flu syndrome primarily affects the upper respiratory tract, along with a low fever and some systemic symptoms such as sore throat, cough, nasal decongestion, headache, and so on. Several clinical studies have shown that combining analgesics, antihistaminics, and decongestants provides better symptom relief in the common cold. The current post-marketing surveillance study was designed to look into the safety and efficacy of commercially available Flucold Drops in the Indian population. Methodology :A current prospective, single arm, multicenter, post-marketing clinical study included 224 subjects, 220 of whom completed the study. All patients were given Flucold Drops for three days and then monitored for the next six days. During the study, the incidence of adverse events (AE) and serious adverse events (SAE) was assessed. The efficacy of the Flucold Drops was evaluated using VAS score changes from the beginning to the end of the treatment. The product’s safety was also evaluated using blood biomarkers such as haemoglobin, platelet count, SGOT, SGPT, and creatinine level. Results : Results show the reduction in symptomatic score of common cold and flu syndrome observed after 2rd follow-up visit (0.202+0.325 to 0.139+0.231). During the study, no intervention-related adverse events were observed. Furthermore, no Serious Adverse Events (SAE) were observed in the study or follow-up period. The study found no changes in the levels of blood biomarkers (haemoglobin, platelets, SGOT, SGPT, and creatinine). Conclusions : Flucold Drops are safe and effective in the treatment of common cold and flu syndrome in Children and infants.

Genomic marker assisted identification of genetic loci and genes associated with variation of grain zinc concentration in rice

A study was conducted to examine the genetic divergence and to determine the genetic loci and genes associated with natural variation of grain zinc (Zn) concentration among 28 landraces, improved varieties and advanced breeding lines of rice using candidate gene specific primers. Field evaluation of the experimental material was conducted in randomized block design with three replications and Zn content in unpolished grains of the entries was determined by addition of nitric acid and perchloric acid (1:3) following the procedure ofdiacid digestion method. Statistical analysis revealed the exploitable extent of variability with respect to grain Zn concentration among the entries. Eighteen entries were selected from the two extremes of grain Zn distribution range and subjected to molecular profiling using a panel of 14 candidate genes specific 12 reported and 14 designed primer pairs. Only eight (OsZIP1-1, OsZIP3a, OsZIP4a, OsZIP5-3, OsZIP7-2, OsZIP8b, OsNRAMP7 and OsNAAT1) reported and eight (OsZIP3K, OsZIP4K, OsZIP5K, OsZIP7K, OsNRAMP7K, OsNAAT1K, OsNACK and OsYSL14K) designed primers generated polymorphic amplified products showing sequence length variation due to targeted amplification of candidate genes specific genomic regions. Ample genetic differentiation and divergence were revealed among the entries, which were accommodated into similarity coefficient-based six clusters, remarkably consistent with grain Zn concentrationof the entries. Hierarchical classification pattern of entries was almost completely corroborated by principal co-ordinate analysisbased spatial distribution pattern of their genetic profiles. Molecular analysis based on candidate genes specific primers appeared to be an efficient approach for the elucidation of genetic differentiation and divergence in relation to variation of grain Zn concentration among entries. Hence, these markers can be effectively and efficiently utilized for grain Zn concentration related discrimination of rice genotypes and selection of parental genotypes for grain Zn biofortification. Microsatellites were detected within the candidate genes and amplicons, thereby providing a basis to deduce that the repeat sequence length variation in candidate genes may be a role player in the differential grain Zn accumulation in rice varieties. Single marker analysis established the association of OsNACK, OsZIP1-1, OsNRAMP7 and OsNRAMP7K with grain Zn concentration. Thus, these four markers can be effectively used in marker-assisted selection programme for grainZn biofortification in rice.

Penile Fracture with Rupture of Bilateral Corpora Cavernosa and its Management by Emergency Surgeon

Introduction: Penile fracture is rarely encountered by theemergency surgeon. It is defined as the rupture of the tunicaalbuginea of the corpus cavernosum due to a blunt traumaon an erect penis. Usually one corporal body undergoes atransverse tunical rupture but involvement of both corporacavernosa, corpus spongiosum and urethra have also beenreported.Case report: The authors report a case of penile fracture in a38 years old male patient which was managed by an emergencysurgeon. The diagnosis was reached on the basis of clinicalpresentation. We also highlight the etiology, the process ofdiagnosis, the surgical repair and prognosis of penile fracture.Conclusion: Early repair has the best prognosis. As a urologistmay not be available at all emergency centers, an emergencysurgeon should be well versed with it.

Swine flu awareness in general population

Background: By simple hygiene and sanitation measures for cough, swine flu transmission can be effectively prevented. The purpose of this study was to know whether the people had enough knowledge about swine flu (H1N1) and to assess their knowledge about possible preventive measures to be taken including vaccination against swine flu epidemics.Methods: A cross-sectional study was conducted during November to December 2018. 200 residents were surveyed.Results: In our study, 196 (98%) of respondents were aware of swine flu infection, 170 (85%) of respondents knew that swine flu is due to viral infection while 130 (65%) of respondents were aware that swine flu infection spreads through air while sneezing and coughing. 192 (96%) of respondents knew fever as symptom of swine flu, 166 (83%) of respondents knew cough and cold as symptoms while 128 (64%) of respondents knew headache and body ache as symptoms. 188 (94%) of respondents were aware that vaccination against Swine flu can prevent swine flu infection. 160 (80%) of respondents knew that covering mouth and nose while coughing and sneezing can prevent spread of Swine flu infection while 104 (52%) of respondents knew that frequent hand washing helps in preventing spread of Swine flu infection.Conclusions: The present review concluded that majority of the respondents had substantial knowledge regarding swine flu, yet there were notable deficiencies regarding the transmission, preventive measures and availability of vaccine. There is need for appropriate training regarding infectious diseases and continuous education programs.

A comparative study on vaccination default rates among children aged 9-24 months attending a static immunization clinic in urban and rural area of Bangalore

Background: Immunization contributes significantly to the achievement of millennium development goal number 4 and is one of the eight elements of primary health care. Effective utilization of immunization services is associated with reduced infections in young children with immature immune system and improved child health outcome. The objectives of the study were to compare the default rates for vaccine doses in immunization schedule; to study the factors responsible for default; to describe the socio-demographic profile of study subjects.Methods: An observational study was conducted in the urban and rural Primary health centre on immunization days for 3 months. The study subjects were children aged (9-24) months attending immunization clinics. Their care givers were interviewed regarding socio-demographic profile and causes for default. Sample size calculated was 184 (92) each from urban and rural clinic).Results: Among 184 care givers interviewed, mean age of study subjects was 14.9±4.6 months in urban & 14.6±4.9 months in rural clinic. Default rates for vaccination were 5.4% (birth dose), 7.6% (6th wk.) both in urban & rural clinic. However, for further doses i.e., 10th week, 14th week, 9 months and 18 months the default rates were slightly higher in rural compared to urban clinic. Commonest reason for default was mother not aware that child had missed dose (urban 52.2% and rural 42.3%) followed by child being sick (urban 26.6% and rural 30.4%).Conclusions: The overall default rate was found to be very high which is a serious concern and need to be addressed in order to prevent eventual dropouts.

Role of diffusion weighted MRI in characterization of renal diseases

Background: MRI has the unique ability to show both structure and function objectively without any radiation exposure to the patient. Apparent diffusion coefficient (ADC) is a quantitative parameter that combines the effects of capillary perfusion and water diffusion. Renal parameters have shown inverse relationship with the ADC values in these studies. So, ADC values have a potential to serve as a marker of renal function. The aim of the present endeavor was to study the role of DW MRI in characterization of renal function and to find out the clinical use of DW MRI in renal diseases; and establish the relationship between renal function assessed by eGFR and that by DW MRI calculated in terms of ADC values in various renal diseasesMethods: Total 30 patients were included in the study. The study was carried out in department of radiodiagnosis at Dr. RPMGC Kangra. 1.5 Tesla MRI machine was used. The ADC value was calculated at upper, mid and lower pole of each kidney and the mean was taken. Then the mean of right and left kidneys was taken to calculate the mean ADC of the patient.Results: Serum creatinine in present study ranged from 0.67 to 13.9mg/dl, with mean value of 7.28mg/d. Serum urea ranged from 22 to 293mg/dl with the mean of 119.6mg/dl. There was significant inverse correlation occurred between ADC values and serum urea (r=-0.43, p=0.02). There was significant inverse correlation between ADC values and serum creatinine (p=0.01) and a positive correlation between eGFR and ADC values (r=0.14, p=0.47).Conclusions: ADC values consistently decreased with increasing stage of renal failure, so these can be used as an indirect maker of renal function. Authors conclude that lower would be the ADC value more advanced would be the stage of renal failure. DW MRI can also be detect early stages of renal failure even when the serum maker are within normal range.

Anthropometric Comparison Of Ear Lobule Among Males Of Haryana And Himachal Region

In recent years, external ear and its prints have developed important role in medico-legal practice. It suggestedbeing an identification tool analogous to fingerprinting as well as facial recombustion. Different ethnic groupshave different parameters in relation to the various body parts and furthermore population specific standardscan give accurate statistical estimation of biological attributes. Therefore, this study was done to establish thecomparison of ear lobe dimensions in two population groups (Haryanvi and Himachali males). In present study,morphometry of ear lobule and its prints was done in 200 healthy males (100 Haryanvi and 100 himachali) in theage range 18-40 years. Significant difference was found in the lobular height in both the methods. Lobular heightis more in Haryanvi males as compared to the himachali males. No significant difference was seen in the lobularwidth in both methods. Lobular index was significantly higher in Haryanvi males than Himachali males.

A Comparative Study of Efficacy of Local Corticosteroid Injection Versus Ultrasound Therapy in the Treatment of Planter Fasciitis

Background: Plantar Fasciitis is a frequent disorder involving the plantar fascia. Usually, syndromes that involvemanifestation of the typical heel pain are called plantar fasciitis. Common treatments can be divided into noninvasive and and invasive treatments, such as corticosteroid injection (CSI), botulinum toxin injection, platelet-rich plasma (PRP) injection and surgery. Methods: Total 80 patients were taken up for the study that completed the follow-up. Patients by random sampling were divided in two groups. Patients were divided in Conservative ultrasound therapy and Local Steroid Injections group of 40 patients each. Results: Treatment outcome was found almost similar in both treatment group, the betterment was found better with ultrasound with more duration of treatment but this is not statistically significant. Conclusion: Findings of our study suggest that As both treatment modalities are at par on comparison of their treatment outcome it is better to go for conservative approach.

Prevalence of Upper Limb Neuropathy in Rehabilitated Spinal Cord Injured Patients in North India

Background: Upper extremities are principally adapted for grasping or seizing activities. In individuals with spinal cord injury, they are additionally used for transfers, wheelchair propulsion, and daily living activities, putting additional strain on the joints. For this reason, it is essential to distinguish the effects of these increased demands in terms of prevalence of peripheral neuropathies in rehabilitated spinal cord injured population from developing countries. Methods: Spinal cord Injury patient with a neurological level below T2, who were independent in activities of daily living was monitored during the yearly follow up. Electrodiagnostic study of median, ulnar, radial nerve was graded in a scale of 0-2 with 0 being normal, 1 being neuropathy of one hand and 2 being an association of both the hands and the final conclusion was based on this study. Results: There were 45 wheelchair users, 5 walker users, 30 elbow crutch users, 10 subjects using sticks and one subject with a unilateral transtibial amputation using an axillary crutches. Thirty eight patients were using tricycle for independent mobility. Among 55 patients using wheel chair CTS was observed in 70% patients. In the same group 24% had ulnar neuropathy and 16% had radial neuropathy.Conclusion: Findings of our study suggest that upper limb compressive neuropathy was highly prevalent among the spinal cord injury patients. Further, current study recorded carpal tunnel syndrome was the most common neuropathy incorporated with paraplegia patients especially using wheel chair and crutches. We strongly advocate for the importance of the modification of in the vocational instruments like light weight or electrical wheelchair etc along with improvement in accessories like grip style, gloves etc to avoid the constant pressure and repetitive trauma to upper limb of paraplegia patients with spinal cord injury

A Clinico- Epidemiological Study Of Hydronephrosis At Era`S Lucknow Medical College, Lucknow

Hydronephrosis is defined as aseptic distension of the renal calyces and pelvis with urine as a result of partial obstruction of the outflow of urine. It is a clinical condition which is caused by dilatation of the renal collecting system most frequently caused by incomplete or complete obstruction. Although this condition is quite common yet its incidence and prevalence, aetiology, diagnosis and management is less commonly reported in literature especially in context with adults and non-pregnant women. This prospective study was conducted to evaluate the etiology, classify causes of hydronephrosis and to study common clinical presentation of Hydronephrosis. hydronephrosis was seen as a highly male dominant disease with renal calculi as the major aetiology and BPH and VUR being age-associated risk factors. Aetiology based management of hydronephrosis yielded good outcome. The present study is perhaps the first detailed clinco-pathological profile of hydronephrosis.

Comparative Evaluation of Cost – Effectiveness and Medication Adherence Between Olanzapine and Iloperidone in Patients of Psychosis

Background: To assess the cost – effectiveness between Iloperidone and Olanzapine in relation to different measures of effectiveness and to evaluate significance of medication adherence and costs and outcomes. Methods: A prospective, randomized, comparative, flexible dose clinical study of 1 year duration was conducted in 100 first episode (drug naïve) cases of psychosis attending to psychiatric outdoor patient department of Rohilkhand Medical College and Hospital, Bareilly. 50 patients each in olanzapine (OLZ) and Iloperidone (ILO) group comprised the sample size. Patients were regularly evaluated by senior psychiatrist for dose titration. OLZ 10-20mg/day and ILO 6-12mg/day were used. Least expensive brands available in our hospital pharmacy were used. Cost – effectiveness and medication adherence were measured as per the formula. Results: It was observed that ILO (8mg/day) controlled 65-75% cases and 12mg/day dose controlled > 90% cases of psychosis. Whereas OLZ showed this level of control respectively with 10 – 15mg/day (average 12.5mg/day) and 15-20mg/day (average 17.5mg/d). Since olanzapine in 15-20mg/day dose cause more metabolic adverse events particularly obesity, hyperglycemia and dyslipidemia which need further management hence overall olanzapine is not cost-effective. 42(87.5%) cases had medication possession ratio (MPR) >90% in ILO group compared to 18 (37.5%) cases in OLZ group. Increased medication adherence led to better control and outcomes. Patients with <90% MPR had developed more adverse events and were mostly living in rural areas. Conclusions: Iloperidone is comparatively more cost-effective than olanzapine to control > 90% of patients on long term use.