Background: PPH accounts for merely 23% of maternal mortality in developing countries. Misoprostol is a uterotonic agent and is a PGE analogue commonly used in management of PPH. Oxytocin is another uterotonic agent which is now been introduced as intramuscularly effective agent to prevent PPH.This study aims to compare rectal misoprostol with intramuscular oxytocin in reducing blood loss in third stage of labor to prevent PPH. Objective of present study is to compare the clinical effect of rectal misoprostol with intramuscular oxytocin in prevention of PPH.Methods: A randomized study was conducted over duration of 3 months, at Department of OBG, BRIMS, Bidar, Karnataka, India. Patients with singleton pregnancy with the history of one previous LSCS and opting for elective LSCS were included in the study. Patients with risk pregnancy, such as pre eclampsia, cardiac disease and asthma or grand multipara were excluded from the study. Immediately after spinal anesthesia rectal misoprostol was given while oxytocin was administered after delivery of the baby. Incidence of PPH and amount of blood loss was observed and compared.Results: The difference in both the groups with regard to mean amount of blood loss, mean duration of the third stage of labor, and mean amount of fall in hemoglobin level was not statistically significant as P value was >0.05. The incidence of PPH and the need for additional oxytocic are slightly more in the misoprostol group. The incidence of shivering and pyrexia was more in the misoprostol group, but not so disturbing so as to lead to disuse of this drug.Conclusions: Oral misoprostol, though not a replacement of parenterally administered oxytocin, can be used safely in all deliveries for the prevention of postpartum hemorrhage.
OBJECTIVES:
The objective was to evaluate the efficacy of antiviral agent valacyclovir compared with famciclovir in the treatment of herpes zoster.
MATERIALS AND METHODS:
A comparative study was conducted over a period of 1 year. Data relevant to the study were collected from 60 patients, with active herpes zoster presenting to the outpatient department within 72 hr of the first occurrence of zoster rash. They were divided in to two groups of 30 patients each. The first group of patients received valacyclovir tablet 1000 mg thrice daily, whereas those in the second group were given famciclovir tablet 500 mg thrice daily. Both the drugs were given for 7 days. Periodic follow-up till 29
th
day was done for assessment of the effects of given drugs.
RESULTS:
Significant decrease was observed on comparison of pain scores between the two groups using the visual analog scale, with the drug valacyclovir, than in the famciclovir group at day 29. Furthermore, valacyclovir treatment accelerated the resolution of zoster associated pain in more number of patients compared with famciclovir.
CONCLUSION:
Oral valacyclovir administered during acute zoster infection for a period of 7 days offers significant benefit compared to famciclovir by providing a well tolerated and greater resolution of pain while maintaining the favorable safety profile, making valacyclovir more efficacious and a better drug in management of Herpes Zoster in comparison to famciclovir.
Background: In dermatology practice Glucocorticoids are the most commonly prescribed drugs. Steroids produce dramatic relief in inflammatory and pruritic skin conditions, if they are irrationally used they may lead to adverse effects. Hence this study was done to observe the prescription pattern of corticosteroids.Methods: It was a prospective observational study. The prescriptions of patient attending the dermatology OPD were screened for the usage of the corticosteroids. The demographic data, chief complaints, diagnosis and the details of the drugs were collected and analysed.Results: Out of 415 patients screened, 13.97% were prescribed corticosteroids. Corticosteroids prescribed by generic name were 26.01% and brand name was 82.05%. Corticosteroids alone were prescribed in 42.02% and along with antihistaminics/antibiotics/emollients in 66.04%. Corticosteroids were prescribed topically in 86.02% of patients and systemically in 22.04% of patients. Moderately potent steroids prescribed in 80.42% followed by potent (15.07%) and very potent steroids (12.56%). No fixed dose combination drugs were prescribed.Conclusions: The corticosteroids prescribed by brand names (82.05%) were more than generic names (26.01%), information about the strength of the steroid was not mentioned and usage of emollients was less. This indicates the need for continuous medical education for the clinicians.
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