||ABSTRACT Background: Children constitute 40% of India's population. They tend to suffer more frequently from illnesses, when compared with adults and elderly. Most of these illnesses are self-limiting. There are reports that these illnesses are treated inappropriately leading to polypharmacy. Children are more vulnerable to the various adverse events related to the use of drugs. Though many studies have been carried out to evaluate the drug prescribing pattern in adult patients, but similar studies in paediatric population are limited. Aims and Objective: To evaluate the pattern of drug prescribing and dispensing in pediatric outpatient clinic in a rural tertiary-care teaching hospital using WHO Core drug use indicators. Materials and Methods: A cross-sectional study was carried out in the pediatric outpatient clinic of Swami Ramanand Teerth Rural (SRTR) Medical College, Ambajogai, Maharashtra, India. Data were collected by scrutinizing the prescriptions written by the treating physician in pediatric outpatient clinic, using WHO core drug use indicators and by interviewing parents of 300 children attending outpatient clinic. Result: The average number of drugs per prescription was 3.4 and actually dispensed was 2.5. There was a high trend of using brand names (49.6% of prescriptions) while prescribing than generic names. Use of antibiotics (60.6% of prescriptions) was frequent, but injection use (0.8% of prescriptions) was very low. A high number of drugs prescribed (77.5%) conformed to WHO list of essential medicines for children and were dispensed (69%) by the hospital pharmacy. The parents' understanding of the correct usage of drugs was low (59%), and only 10.5% of drugs were adequately labeled. The copy of an essential drugs list was not available. The availability of essential drugs was 75%. Conclusion: This study highlights the problem of overprescribing of antibiotics, inadequate labeling, and a trend toward polypharmacy. The prescribing from WHO list of essential medicines for children was fair; the use of injections was low. Interventions to rectify overprescription of antibiotics, use of brand names, and inadequate labeling of drugs is necessary to improve rational drug use.

Primary transitional cell carcinoma (TCC) of the ovary is a rare and recently recognized subtype of ovarian surface epithelial-stromal cancer. Pure forms of the TCC ovary account for only 1% of surface epithelial carcinomas. The clinical presentation is indistinguishable from other types of ovarian cancers. They have a favorable response to chemotherapy than other surface epithelial cancers. We report a case of 55-year-old woman who presented with a hard mass in the abdomen. Computed tomography-diagnosed it as a carcinoma of the ovary. Tumor was immunoreactive with Wilms’ tumor protein-1 and nonreactive with cytokeratin 7 (CK7) and CK20. Histopathology diagnosis of primary TCC of the ovary was made. These tumors are needed to be differentiated from metastatic TCC from other sites and undifferentiated carcinomas of ovaries. Clinical features and immunohistochemistry are helpful. Surgical resection is the primary therapeutic approach followed by standardized chemotherapy.

Objectives: To study the trends of drug utilization pattern in neonatal intensive care unit (NICU) at rural tertiary care hospital using the World Health Organization core indicators. Methods:The study was cross-sectional, observational study in NICU of Government Medical College, Ambajogai, Maharashtra. Data were collected by scrutinizing the prescriptions written by pediatricians in NICU. The consent of parents of neonate was obtained for inclusion in the study. Parameters such as age, gender, birth weight, current illness, congenital anomalies, gestational age at birth, and drugs prescription analyzed. Results:A total 220 prescription were scrutinized. Out of 220 neonates, 53.6% was males and 46.3% females. The total number of drugs prescribed was 808 and the average number of drugs per prescription was 3.6. The most frequently prescribed therapeutic class of drugs antimicrobial agents (60.64%) followed by vitamin K (26.7%) and aminophylline (9.4%). The maximum number (50%) of neonate born with birth weight <2.5. The maximum number (42%) of neonate was born at 34-36 weeks of gestation. Preterm low birth weight was the most common observed reason for admission to NICU. The drugs are prescribed by branded name outnumbered than generic name. Conclusion:This study highlights the problem of overprescribing of antibiotics, inadequate labeling and a trend toward polypharmacy.

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