Rheumatoid Arthritis is an autoimmune disorder of unknown etiology. There is no one stop therapy that can cure the disease. The goal of therapy in Rheumatoid arthritis is to induce prolonged remission. Disease Modifying Anti rheumatic Drugs (DMARD) are the drug of choice, can be used either in monotherapy or in combinations of DMARDs. Among all of these DMARD‘s, commonly methotrexate based combined therapy is used to control the disease. Our present study is to evaluate the response of the drug therapy on disease process and compare the efficacy of the two regimens Methotrexate + Lefunamide vs Methotrexate +Sulfasalazine +Hydroxychloroquine using ACR 20 guideline and also to study the adverse event occuring during this study period. It is a prospective observational study carried out in the department of Pharmacology and Rheumatology outpatient department of R.G. Medical College and Hospital, kolkata. Treating physicians prescribed the drugs according to the condition of the patients without any randomization. Patients were divided into two groups, Group A 60 patients who had been prescribed Methotrexate +Leflunomide, 60 patient of another group (Group B) were prescribed Methotrexate+ Sulphasalazine +Hydroxychloroquine. A questionnaire containing 20 questions (HAQ DI) were given to each patient for assessment of Physical Function at baseline and after 6 months to evaluate the response to drug therapy. After completion of therapy data were analysed by proper statistical method and it was found that our study had shown that efficacy of MTX+SSZ+HCQ (group-B) was statistically better improvement than MTX+LEF (group-A) using ACR20 guideline (p=0.031).

Immune checkpoint inhibitors open a new door for tumor immunotherapy, but it should not be ignored that some tumor patients are still insensitive to this kind of therapy. The purpose of this study is to analyze the prognostic value of STK11 mutations in metastatic cancer patients treated with ICIs. Information regarding somatic gene mutations of STK11 and patients’ survival time in advanced cancer patients receiving ICIs treatment was downloaded from the cbioportal database. The prognostic value of STK11 gene mutation was analyzed by Log-rank test and multivariate Cox proportional hazards regression analysis. The somatic mutation frequencies of STK11 among all patients were 6.14%, and STK11 gene mutations were mainly distributed in patients with non-small cell lung cancer. The results showed STK11 gene mutation status was associated with shorter survival time, the hazard ratio is1.746 (P <0.0001). The somatic mutations of STK11 were also associated with shorter overall survival in NSCLC patients (P = 0.017). Multivariate Cox proportional hazards regression analysis showed STK11 gene mutation was significantly associated with overall survival (HR= 1.567, 95%CI: 1.209-2.029, P= 0.001). The results of this study suggested that STK11 gene mutation could be used as a negative prognostic marker in metastatic cancer patients receiving ICIs treatment.

The main objective of this contribution is to present a new alternative to effectively diagnose colon diseases in a timely, accurate and cost-effective manner, thanks to using technology. To be more specific, it introduces usage of an expert system that is based on using cluster, discriminant and multidimensional analyses and four biochemical parameters to effectively diagnose m. Crohn, colitis ulcerosa and large intestine cancer.

Background: The term undifferentiated connective tissue disease (UCTD) is used when people have symptoms and laboratory results suggestive of systemic autoimmune disease, but lack enough characteristics of a well defined connective tissue disease such as systemic lupus erythematosus, scleroderma and rheumatoid arthritis. Disease in patients with undifferentiated CTD most commonly evolve into a specific defined form while others remain unchanged. Methods: This was a prospective study of patients seen in a tertiary rheumatology clinic. The study was done over three years between July 2013 to June 2016. Patients with symptoms and signs suggestive of UCTD were included in the study. Only those with significant titre of antinuclear antibody (ANA) were included. Excluded from the study were patients with definite diagnosis of specific CTD. Socio-demographic characteristics of the patients were documented. Family history of autoimmune diseases and the time of diagnosis of UCTD were also documented. Results: Five hundred and two patients were seen in the rheumatology clinic over a period of 3 years. There were 79 patients diagnosed of connective tissue diseases with a period prevalence of 15.7%. Undifferentiated connective tissue disease constituted 10.1%. There were 4 females and 2 males. Patients were aged from 18 to 64 years, with a mean age of 42±5 years. Three patients presented with lupus-like symptoms. Arthralgia was the leading symptom. ANA was uniformly positive and the patient with positive anti Ro/SSA presented with sicca symptoms. Conclusion: UCTD is not completely rare in our environment. A high index of suspicion is however needed to diagnose them.

Value-added pharmacy services (VAPS) are not connected with traditional pharmacy activities and do not include services, related to dispensing of medicines and professional consultation. A cross-sectional study that included pharmacists working in the community pharmacies in Bulgaria was carried-out. The pharmacists` attitudes toward VAPS and an implementation of remuneration were studied. The most commonly offered VAPS were blood pressure (BP) measuring with confirmation of 67.4% of the respondents and blood glucose (BG) measuring - 12.9%, but 42.9% of the pharmacists were willing to provide the different VAPS. Most of the respondents (63.5%) did not support the idea of implementation of a fee for BP measuring, but 53.7% considered it is necessary to charge a fee for BG measuring. VAPS are proven to have added value from societal, healthcare and economic point of view, but additional remuneration should be provided.

Grasscutters are currently being explored as laboratory models for scientific researches. The aim of the study was to Identify and localize Nissl bodies in neurons of the cervical spinal cord segments of grasscutters using cresyl fast violent (CFV) stains and to further measure the neuronal sizes of both anterior and posterior horns of the gray matter of the spinal cord. Six grasscutters comprising of three males and three females were utilized for the study. The studies were done using light microscopically methods. The animals were sacrificed by the method of decapitation and spinal cord was removed by splitting the vertebrae. The segments were fixed, processed, sectioned and stained with CFV for detailed studies of the spinal cord segments of the grasscutter. The result of the present study showed that the gray matter was stained dark purple due to the abundant presence of Nissl bodies in the neuronal cell bodies while the outer zone of white matter stained relatively lighter due to the presence of nerve fibers in the region. The result of the histometrical studies of cell areas in the anterior horn has the mean average of 2.56± 0.13 and the largest cell sizes of the cervical spinal cord was recordedin the anterior horn to be in 6.36± 0.16 while the posterior horn has the smallest cells with mean values of 3.86± 0.24. These findings can be useful in understanding the biology of the rodent.

Zanthoxylum budrunga is a tree worthy of investigation due to its many reported phytoconstituents and properties of rich medicinal value. A comprehensive study on the fruits, stems, and leaves of Z. budrunga was carried out to find out and assess the blood glucose lowering capacity as well as antioxidant potential. In vivo Oral Glucose Tolerance Test (OGTT) and in vitro 2, 2-diphenyl-1-picrylhydrazyl (DPPH) scavenging methods were applied to assess the hypoglycemic and antioxidant potentials of the plant extracts. Methanolic extract of Z. budrunga fruits (MZBF), methanolic extract of Z. budrunga stems (MZBS), and methanolic extract of Z. budrunga leaves (MZBL) showed graded dose-response relationship in OGTT. Most potent blood sugar level reduction was at the highest dose of 400mg/kg body weight with the values of 44.26%, 39.61%, and 36.98% for MZBF, MZBS, and MZBL respectively. Also MZBF, MZBS, and MZBL showed synergistic action with Glibenclamide with the value of 50.34, 43.02, and 45.11% blood glucose reduction, respectively. Comparative order of antioxidant activity was as fruits (IC50 30.6 ppm)>leaves (IC50 68.38 ppm)>stems (IC50 126.83 ppm) where ascorbic acid (IC50 0.17 ppm) was used as standard. The results indicate that Z. budrunga fruits, stems, and leaves have the potential to be used in hyperglycemic condition as folk medicine. Besides these, fruits and leaves may be used as functional food and preventive medicine for oxidative stress disorders like aging-induced disorders, neurodegenerative diseases, liver diseases, cancer etc.

Objective: The present investigation was aimed to assess the effect of Forskolin (FL) against cognitive impairment produced by scopolamine in rats using various behavioral models such as Y-maze, Novel object recognition test (NORT) and some biochemical markers of Alzheimer’s disease. Methods: Rats were assigned to six different groups, each group consisting of six animals. The normal animals received distilled water, 10 ml/kg per orally (p. o.), FL (250, 500,750 µg/kg, p. o.) was administered once daily for two weeks. One the last day of treatment, 90 min. post- administration of the last dose of forskolin, amnesia was produced in rats by administration of scopolamine (3 mg/kg) intraperitonealy (i.p.). Then rats were trained to Y-maze and NORT protocol. Short term memory behavioral responses were recorded after 90 min of training session (retention memory) and 24 h after training (long term memory). Donepazil (3 mg/kg, p. o.) was used as a standard and was administered for 14 days to positive control groups. Biochemical parameters such as reduced glutathione (GSH), Lipid Peroxidation (MDA) and acetylcholinesterase activity were analyzed. Results: Administration of different doses of FL (250, 500,750 µg/kg) once daily for two weeks significantly improved the learning ability and the retention of learned memory in Y-Maze and NORT. Moreover, pre-treatment with FL significantly restored increased lipid peroxidation; normalized glutathione and increased acetylcholinesterase activity. Conclusion: Forskolin enhances cognitive performances of rats against memory impairment by forskolin. Antioxidant activity, mainly inhibition of reactive oxygen species generation by natural diterpenoid compound forskolin advocates its therapeutic efficacy in treating neurodegenerative diseases.

Very few ethnic groups in Cameroon have been subjected to ethnobotanical surveys and data on plants having medicinal properties against sinusitis which are very scarce. The current study is about exploring the Cameroonian flora in order to promote traditional medicine in the treatment of this affection. Ethnobotanical surveys were conducted among traditional healers and herbalists from villages and local markets in the Centre, Littoral, East and West provinces in order to identify the plants used by these four major cultural groups in Cameroon to treat sinusitis. After recipe characterization, the plant specimens were harvested and identified. Their floristic characterization and finally determining the composition of their bioactive metabolites were done. A total of 78 recipes involving 52 medicinal plant species were identified for sinusitis treatment; these recipes were prepared using plant combinations. These plants belong to 29 families, the most represented belong to the Fabaceae (7 species), Rutaceae (5 species) and Rubiaceae (4 species) families. 73.00 % are woody plants from which the bark (56.00 %) is mainly collected. Fruits of Massullaria acuminata (29 occurrences), bark of Piptadeniastrum africanum (17), Erythrophleum suaveolens (9), Mammea africana (9), Cylicodiscus gabunensis (6) and leaves of Nicotiana tabaccum (5 occurrences) are the most commonly used organs to prepare the recipes which are mainly administered by nasal instillation (60.77%). The bark of Antrocaryon klaineanum (6 occurrences), the stems of Costus afer (6) and the fruits of Citrus lemon (5 occurrences) are used as plant combinations. These plants are forest species (62.00 %) with regional distribution (40.00 %) whose diaspores are spread by zoochory (97.00 %). They contain many bioactive compounds, in particular phenolic compounds responsible for their pharmacological activities and thus justifies their use in the traditional treatment of sinusitis.

Self-medication is taking any therapeutic drug without doctor's prescription. This practice is a potentially hazardous public health problem. It is commonly practiced in India as it provides a low-cost alternative treatment. Our objective was to find out the correlation between self-medication in medical vs. nonmedical students. It was a cross-sectional study, carried out using a pre-validated, semi-structured, self-administered questionnaire, a medical and a anon-medical undergraduate group consisting of 100 students each. Established statistical methods were used for analysis. It was found that 68% of the medical students self-medicated compared to 48% of the non-medical counterparts, higher in females. Awareness about side-effects, disadvantages, need of correct dosage and importance of course completion was more among the medicos. Upon analyzing the data from medical and non-medical groups we observed that most of them cited mild illness (82% and 69% respectively) as a reason for self-medication. Common-cold was the most common complaint and antipyretics (78% and 77% respectively) were the most commonly taken drug. Drug stores (78%) were the primary sources of obtaining medicines, while previous medication experience from the same illness was the main source of knowledge of dosage. More than 50% participants supported the use of self-medication in the treatment of common illnesses. Conclusion is that main reason of self-medication among medical students can be a better knowledge and understanding about the various aspects of medication, reflecting the influence of medical training and studies. However, an incomplete knowledge and understanding makes self-medication a potentially harmful practice.

The association of celiac disease and idiopathic portal hypertension is a rare entity whose etiopathogenic mechanism has not yet been elucidated. We report two cases of celiac disease associated with idiopathic portal hypertension. In both cases celiac disease diagnosis was made based on the positivity of anti-tissue transglutaminase IgA and villous atrophy on the pathological study of duodenal biopsies. Idiopathic portal hypertension was retained after complete biological, radiological and endoscopic assessment excluding all possible causes that can manifest as portal hypertension. Both patients improved after gluten-free diet.

Corticosteroids have proved to be extremely effective in the treatment of acute inflammation and chronic inflammatory diseases. Drug utilization review (DUR) is an on-going, systematic, criteria-based program of medicine evaluations that will help ensure appropriate medicine use. The present study aim was to evaluate the drug utilization of Corticosteroids in the various department of a tertiary care teaching hospital, Khammam. A prospective observational study was conducted to evaluate drug utilization pattern of corticosteroids. Total 249 corticosteroids were prescribed Prednisolone was prescribed in 39.5% prescription followed by hydrocortisone in 27%, budesonide in 19%, methylprednisolone in 15.5%, Dexamethasone in 9.5%, Deltazacort in 7.5%, Prednisone in 4.5% and Fluhydrocortisone in 2% respectively. 34 ADRs were detected in the study due to corticosteroid use, facial puffiness was detected in 12.50%, headache in 14.70%, Hypernatremia in 14.70%, Hyperglycemia in 17.64%, hypertension in 26.47% and osteoporosis in 14.70%. 72.6% of the drugs were prescribed from the NELM list. Clinical pharmacists interact directly with patients in several different ways. Hence, the clinical pharmacist can perform potential role in health care system in assisting physician in altering the number of medications taken, the number of doses taken, improving the patient medication adherence, detect the adverse drug reactions, drug interactions, in patient counselling, improve the health related quality of life and decreasing the health care cost of the patient.

Objective: To assess the iron status in children with sickle cell disease (SCD) and trait (SCT). Design: Prospective, observational, descriptive study. Setting: Referral tertiary hospital in the state of Jharkhand. Methods: 108 consecutive patients of SCD and trait were enrolled and complete hemogram, serum iron and serum ferritin were measured. Results: Patients with SCT were more at risk of having iron deficiency (ID) than SCD.ID was present in patients who had not received or received <5 units of blood transfusion (BT).High iron level was found in all the patients who had received more than 10 units of BT. Serum Ferritin level had linear relationship with units of BT. Conclusion: Patients with SCT were more in number than that of homozygous SCD (2.6:1). Patients with SCT had more chances to have ID than homozygous SCD.

meconium aspiration syndrome (MAS) in relation to outcome in terms of need for ventilation and mortality. Methodology: This study is a prospective observational study of late preterm>34 – 36 6/7 weeks and term neonates with moderate and severe meconium aspiration syndrome (MAS) admitted in Dr B C Roy Postgraduate Institute of Pediatric Sciences, Kolkata. Study was done by application of surfactant within 24 hrs and 25 to 48 hrs of birth. Requirement for supplemental oxygen and ventilation were recorded in predesigned proformas. Results: The outcome in terms of death between within 24 hrs and 25-48 hrs of birth application of surfactant in MAS is mortality in the former was 3/20(15%) as compared to 2/10(20%) in the latter though it was not statistically significant (p =0.301) .Mean duration of ventilation,( p=0.026)supplemental oxygen requirement(p=0.039) and the length of hospital stay(p=0.045) were significantly lower in those who received surfactant within 24 hrs of birth in comparison to who received within 25-48 hrs of birth.(alpha value for p=0.05). Conclusion: Surfactant in a form of bolus therapy within 24 hrs of birth has no role in decreasing the percentage of mortality or morbidity in MAS but however has shown benefit in terms of decreasing the mean duration of ventilation, O2 requirement and hospitalization.

Objective: To study profile of accidental poisoning in 1yr –12 yr children admitted at Paediatric ward in Calcutta national medical college & hospital, (CNMCH) Kolkata from April 2018–March 2019 and their outcome. Method: All children admitted at CNMCH children ward from 1 to 12 year with accidental poisoning excluding all bites-including snake bite, scorpion sting etc. The age group, nature, type of poison, symptom complex & response to therapy were studied. Result: 201 children of 9 month to 12 year with accidental exposure to poisoning admitted in a tertiary care centre. Common age group affected in the study is below 3 yrs (75%).Boy child commonly affected & common poisoning was kerosene oil (52.2%) followed by turpentine oil (14.9%). Among medication, poisoning (4.97%) not only due accidental ingestion but due to overdosing. Other Rare causes of poisoning was Phenyl, Rat killer, Mosquito repellent/oil, bed bug killer etc. Mortality of the patient was 0.49 % .30% cases (>14 days) suffering was prolonged. PICU management was needed in 1.99% cases. Conclusion: Most common cause of accidental poisoning was kerosene ingestion in rural children. Male children of toddler age group was involved commonly.

Euphorbia cyathophora Linn (Euphorbiaceae) is commonly known as Wild poinsettia, fireplant, fire on the mountain, milkweed, widely used for the treatment of constipation, bacterial and inflammatory disease conditions like arthritis and rheumatism. Colourful plants are very dangerous like Daffodil, Lantana, Foxglove and such plants are conserved as a genetic resource and used as food, fibre, fertilizer, fuel and in used in diversely way. Euphorbia cyathophora is one such plant. This review highlights the systematic position, vernacular names, vegetative characters, ecology and distribution, phytochemistry and the economical values of the Euphorbia cyathophora are well discussed.

Aim of the study was to find out the role of biochemical markers in diagnosis of alcoholic liver disease and non-alcoholic liver disease and compared these values with healthy subjects of Rajasthan. Total 300 subjects were selected in which 200 were selected as patients group (alcoholic liver disease (ALD) and non-alcoholic liver disease (NALD) group) and 100 were normal healthy subjects. Total 100 alcoholic liver disease patients in which 91 patients were male and 09 patients were female. In non- alcoholic liver disease group 55 males and 45 females are enrolled. Patients were distributed age wise. Serum cholinesterase and serum 5-nucleotidase were estimated by commercially available kit on spectrophotometer. Serum cholinesterase level is 2822.99± 716.51 in ALD patients. In NALD patients, serum cholinesterase level was 4299.95±1014.76 and in control group mean serum cholinesterase level was 6303.99±977.59. P-value was statically highly significant. (P≤ 0.0001), as well as serum 5-nucleotidase level was 25.89± 5.77 and 17.70± 4.43 in ALD and NALD respectively. In control group mean level of serum 5-nucleotidase was 9.851± 3.24. (P≤ 0.0001). We conclude that serum cholinesterase level was decreased in both disease group, whereas serum 5-nucleotidase level is increased in both disease groups. Both parameters are liver specific and specific test for alcohol induced or alcoholic liver disease as well as in non-alcoholic liver disease. Both parameters can be used as a marker of liver disease. it was concluded that serum cholinesterase and 5' -nucleotidase are better diagnostic marker then the conventional liver function test that are raised in other liver disease also.

Facial nerve schwannoma is an uncommon benign tumor, which is rarely encountered in the parotid gland, and mimicking the tumors of this gland. It’s a neurogenic lesion that arises from Schwann cells of peripheral nerve sheath. Most of cases, it is localized in the intratemporal segment of the facial nerve, only 9% that occur in the extratemporal segment. Intraparotid facial nerve schwannoma was firstly described by Ibarz in 1927. Even if the tumor arises from the nerve itself, the function of the facial nerve is generally unaffected. If there is facial paralysis, it is interfered with malignant parotid tumors. Because of the heterogeneity of imaging features, it is difficult to diagnosis and differentiate preoperatively the intraparotid facial nerve schwannoma from other parotid tumors, so the definitive diagnosis is made by histological examination of resected tumor. The management of intraparotid facial nerve schwannoma is a very contested issue within the literature. Because the benignity and low evolutionary potential of the tumor, some authors advocating a conservative attitude with clinical surveillance for patients without facial nerve dysfunction or for tumor localized in the parotid gland. However, if a severe or a sudden facial nerve dysfunction, or extension into the mastoid was founded, the surgical resection of the tumor is indicated without delay. We report a case of a 24-year-old young female, complaining of a slow-growing and painless mass in the left parotid area, associated with grade V facial paralysis on left side since 10 years. No lymphadenopathy was founded in the neck. The computed tomography scan was revealed a heterogeneous tumor, involving in superficial and deep lobes of the left parotid gland, and extending into the parapharyngeal space. On surgical exploration, the dissection of facial nerve and isolation of the mass was impossible. Because the patient had a facial paralysis preoperatively, we had to sacrifice the facial nerve to remove

As pharmaceutical industries now a days concerns with the safety and continuously enhance the quality of the drug products. The development of pharmaceutical industries is based on the innovation of the product as well as the manufacturing process by keeping quality in the mind. In earlier times, the development of pharmaceutical products shows the failure in the quality and hence alters the therapeutic effect of the product. Quality by test (QbT) was the only way to maintain the quality of the drug product before the FDA launches the current Good Manufacturing Practices (cGMP), which was an approach without understanding the processes. So FDA decided to applied the several Design of Experiments (DoE) in the pharmaceutical fields. QbD (Quality by design) was one of the design experiment approved by the FDA to maintain the quality of the drug products before reaching to the market. In pharmaceutical industry, QbD brings cost-efficiency and simplicity of manufacturing process into reality. QbD is a systematic risk-based, proactive approach to pharmaceutical development that begins with predefined objectives and emphasizes product and process understanding and process control based on sound science and quality risk management. The main aim of this review is to discuss the concept of pharmaceutical Quality by Design and describe how it can be helpful to ensure pharmaceutical quality & drug development.

Background: Peak expiratory flow rate (PEFR) reflects the strength and condition of respiratory muscles and the degree of airflow limitation in large airways. PEFR is recorded in Mini Wrights Peak Flow Meter and it is commonly used for screening the individuals who are asthmatics. PEFR shows hour to hour variation that follows a specific pattern in asthmatics and healthy individuals. Circardian oscillations in the sympathetic activity may have impact on the airway smooth muscles. Materials and Methods: Peak expiratory flow rate was recorded in 60 young healthy females in the age group of 18-25years in Sri Ramachandra Institue of Higher Education and Reasearch. Mini Wright’s peak flow meter was used to measure the peak expiratory flow rate. PEFR was recorded at 6-7am, 9-10am, 1-2pm, 5-6pm, 10-11pm in a single day. Results: Our results showed PEFR values were low in the morning, followed by progressive rise peaking in the afternoon and evening and a small fall at night time. Highest PEFR is seen around afternoon. Conclusion: Comparing the PEFR readings there ia diurnal variation there is a diurnal variation in healthy young females showing a overall dip in the morning PEFR at 6 A.M, peaking in the evening PEFR at 6P.M, eventually decrease in night PEFR at 10P.M. But there is no significant in the afternoon (2P.M) and night (10.P.M).

Juvenile Nasopharyngeal Fibroma (J.N.A) is a rare nasopharyngeal tumor that affects male adolescents; it is a benign but locally aggressive vascular tumor due to invasion of adjacent structures. The symptomatology is not very specific; but predominated by epistaxis. His treatment is essentially surgery; however, the use of other therapeutic means: radiotherapy, interventional arteriography, chemotherapy and hormone therapy are of value in the case of locally unresectable advanced tumors. Through our observation of a case of nasopharyngeal fibroma, we discuss the clinical, radiological and histological aspects as well as the therapeutic management of these tumors.

Introduction: Sickle cell anaemia is a monogeneic hereditary disease that manifests as a lifelong multisystemic disorder characterized by periods of relatively stable health punctuated by periods of acute ill health, mostly possibly reversible and an accumulation of chronic complications, mostly irreversible affecting various organ systems with an outcome of persistent morbidity, and the risk of premature mortality. The aim of this study is to identify electrocardiographic changes typical to patients with Sickle cell anaemia (SCA). Method: Fifty three SCA patients and fifty three apparently healthy, age and sex matched adults HbAA subjects were recruited in this case control study. Individuals with other cardiovascular risk factors were excluded from the study. All recruited individuals were evaluated using electrocardiography. Result: There was left and right atrial abnormality in 7.4% and 3.8% of the SCA patients respectively while shortened PR interval was identified in 1.9%. First degree atrioventricular block was noted in 3.8% while features of Right bundle branch block (RBBB) and left bundle branch block (LBBB) were found in 3.8% and 1.9% of SCA patients respectively. Both Left and Right Ventricular hypertrophy with significant ST-T wave changes in the anterior and inferior leads were also observed in the SCA patients (p=0.001). Prolonged QTc was also identified in 20.8% SCA patients (p=0.02).CONCLUSION: Varied ECG abnormalities are common in SCA patients which may contribute to sudden death. Early ECG findings make for timely intervention towards prevention of disease progression.

Background: Drug utilization studies conducted at regular intervals help to guide the physician in prescribing drugs rationally. Methods: This is prospective, observational study was conducted in the outpatient of department of general medicine of Indian Institute of Medical Science & Research a tertiary care teaching hospital. Data was collected from patients who have been diagnosed with hypertension as per JNC-8 guidelines and patients receiving or prescribed with antihypertensive medications were included. Frequency and proportions of utilization of antihypertensive medications in were figured. Results: A total of 170 prescriptions were analysed during the 6 month study period. The patients 93 (46.5%) were on Mono therapy significantly higher than dual therapy, triple therapy and poly therapy, 64 (32 %), 27 (13.5%), 16 (8 %) respectively. Calcium channel blocker was the frequently used class of drug for monotherapy (19.5 %). In dual drug therapies were CCB+ARB accounting for 18.5 %, and 5.8% of patients were on triple drug therapy with CCB+ARB+Diuretic. 30.2% patients were on ACE inhibitors. 25.5 % patients receiving Calcium channel blocker reported side effect. Conclusion: This type of studies gives the base line idea of prescription pattern and ADRs of antihypertensive drugs. These helps to design policy for rational use of drugs and motivation of physician for rational use of drugs. The study emphasizes that need for effective continuing medical education and also preventive measures in hypertensive individuals.

Introduction: Low level laser therapy (LLLT) also known as photobiomodulation, is a treatment that uses low-level lasers or light-emitting diodes (LEDs) to change cellular function and is a clinically well accepted tool in shortening the duration of Orthodontic treatment which is beneficial to the orthodontists as long treatment duration is associated with increased risks of white spot lesions, gingival inflammation, decalcification and root resorption. Low-level laser therapy (LLLT) is reported to accelerate orthodontic tooth movement. Both pulsed (PW) and continuous wave (CW) modes are available in LLLT devices, which provide with a wide range of therapeutic options. The relative influence of CW and PW on Orthodontic tooth movement has not been fully studied. So the purpose of this study was to determine the effects of CW & PW on the effect of OTM. Materials & Methods: This split-mouth design study was carried on 20 patients requiring extraction of first premolars in maxillary arch. Upper Left quadrant canine was irradiated to Continous wavelength (CW) LLLT and upper right quadrant canine was irradiated with Pulsed wavelength (PW) LLLT. Gallium Aluminum Arsenide (GaAlAs) semiconductor diode laser with a wave length of 810 nm was used in two different modes. Laser Irradiation and the Traction Force of 150gm was applied on reaching 19x25 stainless steel wire at various intervals T0, T3, T6.Digital vernier caliper was used on study models as well as direct intraorally to measure the rate of canine retraction at each interval. Results: Data was subjected to various statistical tests- Kolmogorov Smirnov test, student t-test, one way ANOVA test. The rate of canine retraction was 6.58 mm at T0 (starting point) to 4.61 at T6 (6 weeks interval) in continuous wave(CW) group ( p=0.0001) while in Pulsed wave (PW) group it was 6.56mm at T0 to 2.94 mm at T6 (p=0.0001). Conclusion: The rate of canine retraction was greater in the quadrant which was irradiated with pulsed wavelength (PW) as compared to continuous wavelength (CW). More rapid tooth movement was seen between 3-6 week intervals.