Background: Irrational prescription being a global problem leading to ineffective, unsafe treatment. Aiming to measure the performance of a health-care provider in key dimension related to appropriate use of drugs, the World Health Organization (WHO) has developed set of core prescribing indicators. Aims and Objectives: The aim of this study is to assess the drug use pattern using WHO core prescribing indicators. Materials and Methods: This was a prospective, cross-sectional study conducted at K.S. Hegde Charitable Hospital. Around 900 prescriptions from the outpatients attending the Department of Medicine from January to March 2016 were analyzed for WHO core prescribing indicators and was compared with the standard WHO values. Results: Polypharmacy being the common finding, the concept of generic prescribing was negligible. There was reduced prescription of drugs from the National List of Essential Medicines, but the prescription of antibiotics and injections was within normal limits. Conclusions: There was moderate compliance with WHO prescribing indicators.

Objective: To analyze the various Potential Drug-Drug Interactions in ICU patients with the ultimate goal of raising awareness among clinicians on safe medication usage. Materials and Methods: This was a Cross-sectional study conducted at a tertiary care hospital. The medical records of the patients admitted to the ICU of the hospital from January 2017 to June 2017 formed material for the study, were analyzed using the database from Lexicomp ® Solutions android mobile application for Potential Drug-Drug Interactions. Results: Among the 176 patients,81.39% had Potential Drug-Drug Interactions, with cardiovascular drugs (22.6%) being the majority group followed by respiratory drugs (17. 97%). Among these 73.2% of the interactions were clinically relevant with the majority being moderate (72.26%) in severity with fair (72.6%) documentation and belonging to Category C (61.080%) in risk rating. The pharmacodynamics type of interactions was more (59.31%) than pharmacokinetic type (36.13%). Conclusion: The high prevalence of Potential Drug-Drug in the ICU setting emphasizes the need for effective medication management and pharmacological consultation to reduce the adverse effect and improve the therapeutic outcome in these patients.This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Triplet heterotopic pregnancy refers to the presence of specifically 3 concurrent gestations with at least 1 being abnormally implanted. Heterotopic pregnancy is rare and estimated to occur in about 1 per 30,000 spontaneous pregnancies while a higher prevalence may occur in assisted reproduction techniques that may reach up to 1 case per 100 in some literatures. The triplet heterotopic pregnancies are often in association with risk factors, as tubal factor infertility, pelvic infections, in vitro fertilization, more embryos transfer, and use of pharmacologic ovulation induction. A 22-year-old primigravida with history of undergoing ovulation induction treatment with 2 & ½ months of amenorrhea was brought to the Emergency Department with complaints of pain abdomen, vomiting and generalized weakness since one day. Transvaginal ultrasound revealed a single live intrauterine gestation at 9 weeks 3 days with fetal cardiac activity alongwith a well defined round to oval anechoic lesion likely gestation sac within the left fallopian tube with moderate to gross hemoperitoneum leading to the diagnosis of a heterotopic pregnancy with left ruptured ectopic pregnancy. She underwent an Exploratory Laparotomy under general anesthesia and was found to have a left sided ruptured tubal ectopic at the isthmo-ampullary junction measuring about 4 x 5 cms for which salpingectomy was done along with an incidental finding of a right sided unruptured ectopic pregnancy in the ampullary region which was in the process of tubal abortion for which right salpingotomy was done. Hemoperitoneum of 900 ml was present. Serial USG monitoring and regular antenatal check ups were done for intrauterine pregnancy and patient was followed up till term. She was admitted at 38 weeks gestation and delivered a healthy, term male baby of birth weight 2.86 kgs through caesarean section.

Aims and objectives: The aim is to determine the frequency of potential drug-drug interactions (pDDIs) and to analyze the clinically relevant drug interactions among hypertensive pregnant women.Materials and methods: This was an observational, cross-sectional study conducted at a tertiary care hospital. The prescriptions of the hypertensive pregnant women admitted to the hospital from June 2021 to December 2021 were analyzed for potential drug-drug interactions using the database from Lexicomp ® Solutions android mobile application version 7.5.4 (Wolters Kluwer, The Netherlands).Results: A total of 127 patients were evaluated during the study period of 6 months, of which 70 (55.12%) had pDDIs. The total number of pDDIs was 85, of which 70 (82.35 %) were clinically relevant interactions with the majority of them having moderate severity (81.17%) followed by minor severity (17.65%) and major severity (1.18%). The most frequently interacting pDDIs were between Labetalol and Lornoxicam (42.35%), followed by Labetalol and Diclofenac (22.35%).Conclusion: This study highlights the high prevalence of potential drug interactions among hypertensive pregnant women and the need for rational drug use and strict vigilance in their monitoring.

Background: Preterm birth is a major cause of neonatal and infant illness and mortality in developing countries. It is associated with severe suffering for both the mother and neonate as well as long-term disabilities; hence interventions to prevent preterm birth are critical. Therefore, accurate markers for determining whether a pregnant woman is at high risk for preterm delivery could lead to better surveillance and more timely intervention to improve outcomes. Aims: To determine and compare predictive value of cervicovaginal β-Human Chorionic Gonadotropin (β-hCG) and Prolactin levels for preterm delivery in symptomatic women. Materials & Methods: All the consenting eligible pregnant women between 28 to 36 weeks gestation who were hospitalized with symptoms of preterm labour were recruited for the study. One cervicovaginal fluid sample per woman was collected and quantitative estimation of β-hCG and Prolactin with Enzyme Linked Immunosorbent Assay (ELISA) kits was done. They were followed up till their delivery and divided into two groups depending on the outcome i.e., whether they had a term delivery or preterm delivery. Results: A total of 40 women were involved in the analysis of which 28 (70%) progressed to have a preterm delivery and the rest 12 (30%) continued till term. The association between delivery outcome and mean cervicovaginal β-hCG and Prolactin levels was found to be statistically significant with p-value < 0.001. The optimal cut-off value for cervicovaginal β-hCG in predicting preterm delivery was reported to be greater than 15.54 mIU/ml, with specificity, sensitivity, negative predictive value and positive predictive value of 100%, 60.7%, 52.2%, and 100% respectively. Whereas, the specificity, sensitivity, negative predictive value and positive predictive value of cervicovaginal prolactin at a cut-off of greater than 6.24 ng/ml in predicting preterm delivery were found to be 83.3%, 89.29%, 76.9%, and 92.6% respectively. The area under the receiver operating characteristic (ROC) curve for cervicovaginal β-hCG and Prolactin levels was 0.820 and 0.920 respectively. Conclusion: Cervicovaginal Prolactin level was found to be a better predictor of preterm delivery in symptomatic women when compared to cervicovaginal β-hCG level.