Inspite of high incidences of exposures to HIV or Hepatitis B positive source, good efficacy of PEP was observed with no sero-conversion. PEP for HIV was well tolerated; female HCWs were less tolerant. Study emphasized the need for creating awareness about timely reporting of incidence, achieving maximum vaccination against Hepatitis B for all HCWs and need for anti-HBS antibody titre.
Haemoglobinopathies are a frequent cause of anaemia in Northwestern India due to traditional practices of consanguineous marriages. Haemoglobin D-Punjab is one of the most common subvariants (55%) of haemoglobin D, which can be inherited as a homozygous or a heterozygous trait with other haemoglobinopathies. Though, haemoglobin D-Punjab is commonly seen, a heterozygous trait with beta thalassemia is a very rare presentation. Here, we present a rare case of co-inheritance of haemoglobin D-Punjab and beta thalassemia in a 19-year-old male of Indian origin. He came with gradually progressive generalised weakness with easy fatigability for the past two months. No history of similar complaints in the past. On examination, he was pale and icteric with splenomegaly and Grade I hemorrhoids on systemic examination. On investigation, there was severe anaemia, pancytopenia (mixed picture on smear), vitamin B12 deficiency and raised Lactate Dehydrogenase (LDH). Haemoglobin electrophoresis showed co-inheritance of haemoglobin D-Punjab and beta thalassemia. After Pack Cell Volume (PCV) and B12 supplements, haemoglobin improved. He was counseled about his disease and advised regular follow-up.
Sheehan’s syndrome is the name given to postpartum hypopituitarism, usually precipitated by massive uterine haemorrhage and hypovolemic shock during or after childbirth resulting into pituitary injury in varying degrees. Most cases are diagnosed very late in life and the first presentation may be a life-threatening situation like shock or cardiorespiratory collape. This hidden nemesis in women compromises their quality of life and may result into mortality if not suspected early. In this article we present 3 patients who presented in the ICU in a state of complete cardio-respiratory collapse and later discharged in full health.
It is a cross sectional study conducted at outpatient department (OPD) in Shree Krishna Hospital, Anand, Gujarat during the month of September to October, 2012. Patients, who have temperature greater than or equal to 99°F analyzed by the physician in Medicine OPD.A total of 451 medicines were prescribed to 101 patients during the 2 months study period. The mean number of medicines per prescription was found to be 4.46. Oral route was the most preferred mode of administration. Monotherapy therapy (95.50%) was more prevalent than combination therapy (4.50%). An overwhelming tendency for prescribing medicines by brand names (58%) was observed by the physicians. The most frequently prescribed class of medicines were antipyretics>;antihistaminic>;anti‐ulcer >;antimicrobials >; gargles >; expectorants. Non traditional methods of treatment such as warm saline gargles and steam inhalation was profoundly practiced.There is a considerable scope of improvement in the existing prescribing practice, especially prescribing by generic names, needs to be encouraged and a hospital formulary has to be upgraded accordingly. The number of medicines to be included per prescription should be judged and polypharmacy ought to be curbed. Usage of medicines also needs to be rationalized as over usage may lead to the drug interactions and noncompliance.
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