Drug utilization study in neonatal intensive care unit at tertiary care hospital

SUMMARY OBJECTIVE: Neonates are more susceptible to drug interactions and adverse effects, and special care should be taken when prescribing medication to them. This study aimed to investigate drug usage in the neonatal intensive care unit of a tertiary care hospital. METHODS: This prospective observational study was conducted on 98 patients at the Apollo tertiary care hospital (Bannerghatta, Bangalore, India) in a period of 6 months. The most common indications for neonatal intensive care unit admission, average number of drugs per patient, the most frequently used medication, distribution of patients based on the birth procedure, and possible drug interactions were collected from patient profiles. RESULTS: Among the patients, 52% were males and 48% were females. Notably, 38% of patients were preterm, 60% were term, and only 2% were post-term. Also, 80.6% were born by cesarean section and 19.4% were born by normal vaginal delivery. The highest mean of drug use was in the patient of 1,000-1,500 g (8.06 per patient). Preterm was the most frequent indication for admission in neonatal intensive care unit, followed by hyperbilirubinemia and then respiratory distress syndrome. The most frequently used medication was vitamin K (99%) and antibiotics followed by dextrose. In different types of antibiotics, amikacin (41%), cefoperazone+sulbactam (35%), cephalosporin (1%), ceftriaxone (0.7%), and amoxicillin (0.3%) were commonly administered. There were some possible interactions, such as aminoglycoside with furosemide and calcium gluconate. CONCLUSION: Premature birth and resulting low birth weight were the main reasons for drug prescription. High administration of antibiotics is probably an area of concern and should be seriously considered.

Efficacy of triple therapy with PPI or H2 antagonist versus the elimination of helicobacter pylori

O Helicobacter pylori tem sido considerado importante fator nas doencas gastroduodenais e o esquema chamado triplice e o que mais se aceita no momento para a sua terapeutica. Neste estudo incluiram-se 14 pacientes portadores de gastrite cronica, 30 com ulcera gastrica e 16 com ulcera duodenal. Foram divididos em 2 grupos homogeneos para tratamento clinico, cada um com esquema bem definido: grupo A - claritromicina 250mg/2, tinidazol 250mg/2 e omeprazole 20mg em caso de gastrite e 40mg em caso de ulcera; grupo B - mesmos antibioticos e ranitidina respectivamente nas doses de 150 e 300mg. O periodo de tratamento foi de 7 dias para gastrites e 4 semanas para ulceras. Atraves de endoscopia e biopsia realizadas 30 dias depois do termino do tratamento, os 30 casos do grupo A tiveram erradicacao completa do Helicobacter pylori e cicatrizacao das ulceras. No grupo B, apenas 3 casos nao tiveram eliminacao do Helicobacter pylori. Concluiu-se que o uso de bloqueadores H2 no lugar de inibidores da bomba protonica tambem permite a obtencao de sucesso terapeutico

Review of the effects of Cannabis on mental and physiological functions: justification for an intensive and comprehensive programme for the health of the Caribbean people

This paper draws on scientific work done in the English-speaking Caribbean in an attempt to assess the specific effects of the chronic use of Cannabis on psychological and physiological processess. Evidence is reviewed concerning the interaction of this psychotomimetic compound on cognitive functioning and the possible sequelae of altered mental states giving rise to psychopathology. The physiological work evaluates studies relating to Cannabis smoke and lung function. In addition, the work reveals some exciting findings of the impact of Cannabis on the reproductive process. The implications of these findings are discussed in view of our knowledge of the chronic use of Cannabis in Jamaica, and focusses attention on the long-term effects of this substance in the context of the abusing population

Test for autonomic function to establish the norm: a useful tool for evaluation in various clinical disorders

Little information is available regarding the responses of the Jamaica population to the Valsalva manoeuvre (VM), a test to investigate the integrity of the autonomic nervous system (ANS). This study is aimed at investigating the cardiac automonic control in the Jamaican population, to explore the range of responses and to establish the norm. Such an explorative investigation provides an important tool to uncover autonomic dysfunction in psychosomatic, cardiopulmonary, metabolic and neural disorders. Fifity male and fifty female Jamaicans, who were apparently healthy and did not indulge in any drug use and smoking, are asked to perform the VM in a semirecumbent position. A tachograph (Grass model) and standard electrocardiographic leads are used for the graphic presentation of the subjects' beat-to-beat heart changes. The Valsava ratio (VR) is calculated by dividing maximum tachicardia and maximum bradicardia during the VM. The mean VR for the female (2.41 ñ 0.18) is greater than for the male (1.63 ñ 0.27) p < 0.001). Female subjects exhibit a higher basal hearth rate (88 ñ 6 as aginst 77 ñ 7 in the male) and a greater magnitude of bradycardia (33 as against 4 in the male). The values for VR are above the minimum of 1.5 proposed in the literature. Relatice roles of the sympathetic and parasympathetic nervous systems may differ in the male and the female subjects, thus accounting for a higher VR in the female. This test is simple, safe, noninvasive and reproducible and is useful to detect the abnormal autonomic function in various conditions, including states of pregnancy and stress