Drug Utilization Pattern in Medical Intensive Care Unit (MICU) in a Tertiary Care Teaching Hospital in Rural Area of Maharashtra.

Objectives: To study the drug utilization pattern in Medical Intensive Care Unit (MICU) in a tertiary care teaching hospital in rural area of Maharashtra. Materials and Methods: It was a retrospective and observational study, conducted during the period of March, 2013 to August 2013. Data was obtained through the prescription record of 123 patients admitted in the Medical ICU in the hospital from Medical Record Department (MRD) of the hospital. The study was conducted after obtaining permission from the Institutional Ethics Committee (IEC) of the college. Data was analyzed for- Most common causes for admission to MICU, male and female admission ratio, average number of drugs prescribed per prescription, Outcome of the patients, percentage usage of various antimicrobial groups. Results: Most common cause for admission in MICU was found to be Myocardial Infarction (MI) followed by angina. In all diseases number of male patients was found to be more than female patients. Average no of drugs per patients was found to be 7.82, Improvement was seen in 87.23% patients and mortality was seen in 2.23% patients. While condition remained same in 10.54% patients at the time of discharge. Cephalosporins were the most commonly prescribed antimicrobial group (65.33%) followed by aminoglycosides.

Comparision of potency of different types Neuro-Muscular Junction (NMJ) blockers on isolated rectus abdominis muscle of rana tigrina.

The most important use of neuromuscular blockers is as adjuvant to general anaesthesia where adequate muscle relaxation can be achieved at lighter plane. They also reduce reflex muscle contraction in the region undergoing surgery and assist maintenance of controlled ventilation during anaesthesia. They are particularly helpful in abdominal and thoracic surgery, intubations and endoscopies, orthopedic manipulation, etc. Thus, the risk of respiratory and cardiovascular depression is minimized, and post anesthetic recovery is shortened. The potency ratio of two commonly used neuromuscular agents depolarizing succinylcholine and non depolarizing pancuronium. Double pith a frog and fasten it to a frog board with ventral side up. The sternum was cut through just above the xiphisternum at its base and a pair of muscle attached to it were dissected out and transferred to a dish containing frog Ringer solution at room temperature. All the drug containing solutions were freshly prepared before the experiments Succinyl choline, Pancuronium (1,10,100mg/ml and 1mg/dl) respectively Acetyl choline (10,100mg/ml and 1mg/dl). Acetylcholine solution in various strength were prepared starting from 0.1% to 0.0001%.NMJ blocker Pancuronium was added to the biophase in addition to selected dose (128mg or 256mg) and the contraction of muscle till the 70-80% of inhibition is produced and the difference from sub maximal contractions. The median ED50 was interpolated from the figure taking 50%of inhibition from Height of contraction in mm. The ‘t’ test was performed to compare the ED50 value were interpolated from the regression line to find out the ED50 of the drug. The median doses (ED50) of both of them were calculated graphically and compared. The mean ED50 value of succinylcholine was found to be 1.59 ± 0.08μg (95% confidential limit was from 1.53 to 1.66μg). The ED50 of pancuronium was found to be 0.52 ± 0.10μg with 95% confidence limit being from 0.44 to 0.60μg. The ED50 value of the two drugs was very significantly different (P < 0.001). The potency ratio of pancuronium to succinylcholine was 0.32.

Effect of foot-electroshock stress on cholinergic activity, tissue glycogen and blood sugar in albino rats.

The immediate or 24 hr delayed effects of 1-day (1-DS) or (7-DS) foot-electroshock stress in albino rats were studied on cardiac acetylcholine (ACh), blood and cardiac cholinesterase (ChE) activities, cardiac, hepatic and muscle glycogen contents and blood sugar concentrations. The effects of physostigmine (PHY), atropine, 6-hydroxydopamine (6-HD), vagotomy and adrenalectomy on 1-DS induced changes were also studied. 1-DS produced an increase in cardiac ACh content which lasted for 24 hr but repeated stress showed phenomenon of adaptation. There seems to be activation of autonomic cholinergic system in stress. 1-DS and 7-DS produced a short-lived inhibition of blood ChE activity and 7-DS also of cardiac ChE activity. Inhibition of ChE activity was probably related to release of adrenaline from adrenal medulla. 1-DS produced hepatic and muscle glycogenolysis with slight hypoglycaemia but without any effect on cardiac glycogen. Following repeated stress there was a phenomenon of adaptation. The hepatic and muscle glycogenolysis produced by stress is due to the release of adrenaline from adrenal medulla. Normally functioning cardiac cholinergic system seems to have a protective effect on heart against stress, in the absence of which cardiac glycogenolysis is induced by stress.