RESUMEN
BACKGROUND: This systematic review is an attempt to provide an evidence-based analysis of literature on management of severely displaced radial neck fractures (with > 60° displacement) in children. MATERIAL AND METHODS: A systematic literature search was conducted to identify all original articles published between 01/01/1999 and 20/01/17 on surgical treatment of radial neck fractures in children in the following databases: MEDLINE, EMBASE, and CINAHL PLUS. Studies reporting pre-operative fracture displacement and post-operative outcomes according to standard outcome measures were included. RESULTS: Out of 887 studies identified on initial search, 48 were eligible for full-text review and 14 studies with a total of 173 patients were included in the final review. The overall success rate after severely displaced radial neck fractures in skeletally immature patients was 87% (95% CI, 82%, 92%). Closed reduction methods reported higher success rate of 90% (95% CI, 85%, 95%) compared to open reduction methods 77% (95% CI, 63%, 89%). CONCLUSION: The average rate of patients achieving excellent/good outcomes following surgical management after severely displaced radial neck fractures in this review is better than reports from previous reviews. Considering the limitations in current evidence base including lack of direct comparison of techniques and small study samples, large comparative studies controlling for possible confounders are merited.
RESUMEN
BACKGROUND: Medication errors are probably one of the most common types of medical errors, as medication is the most common health-care intervention. Knowing where and when errors are most likely to occur is generally felt to be the first step in trying to prevent these errors. OBJECTIVE: To study prescribing patterns and errors in pediatric OPD prescriptions presenting to four community pharmacies across Nagpur city and to compare the prescription error rates across prescriber profiles. MATERIALS AND METHODS: The study sample included 1376 valid pediatric OPD prescriptions presenting to four randomly selected community pharmacies in Nagpur, collected over a period of 2 months. Confirmed errors in the prescriptions were reviewed and analyzed. The core indicators for drug utilization studies, mentioned by WHO, were used to define errors. RESULTS: The 1376 prescriptions included in the study were for a total of 3435 drugs, prescribed by 41 doctors. Fixed dose formulations dominated the prescribing pattern, many of which were irrational. Prescribing by market name was almost universal and generic prescriptions were for merely 254 (7.4%) drugs. The prescribing pattern also indicated polypharmacy with the average number of drugs per encounter of 2.5. Antibiotics were included in 1087 (79%) prescriptions, while injectable drugs were prescribed in 22 (1.6%) prescriptions. The prescription error score varied significantly across prescriber profiles. CONCLUSION: The findings of our study highlight the continuing crisis of the irrational drug prescribing in the country.