Introduction: Drug utilization evaluation of anticoagulant drugs is essential considering the spectrum of use and associated risks with their therapy. Objectives: The objectives of the present study were to evaluate the drug utilization pattern of anticoagulants, identify and assess drug interactions and ADRs with the use of anticoagulants. Method: 84 patients from the medicine department were included in this prospective, cross sectional study conducted for one year. Results: Heparin was mainly used for prophylaxis. Enoxaparin and acenocoumarol were other commonly used drugs. The diagnosis varied from Ischemic heart disease (IHD), deepvein thrombosis (DVT), pulmonary embolism (PE), cardiovascular accident and others. Laboratory tests like prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), in few cases radiological tests were performed to monitor the therapy. Use of mono therapy and combination therapy aswell as topical use of heparingel was observed. Acenocoumarol and warfarin were the drugs prescribed at discharge. 35 drug interactions were identified, twelve pharmacokinetic and twenty three pharmaco dynamic in nature. Acenocoumarol was the most commonly identified drug with drug interactions. Pharmacokinetic mechanism commonly found was inhibition of vitamin Kactivity; synergistic effect was the mechanism of pharmaco dynamic interaction. Sixteen interactions were severe in intensity.6 adverse drug reactions (ADRs) were observed during the study. Conclusion:The pharmacotherapy with anticoagulant drugs should be cost effective and with minimum risks involved. The study highlights the importance of following the guidelines for appropriate use of anticoagulants.

<p class="abstract"><strong>Background:</strong> Tranexamic acid (TXA) is antifibrinolytic drug which has the property to reduce intraoperative and postoperative bleeding. There are several studies supporting the use of tranexamic acid in total knee replacements (TKR) and few in total hip replacements. Our study was intended to establish the effects of tranexamic acid in minimizing the intra operative and post-operative blood loss in uncomplicated primary total knee replacement.</p><p class="abstract"><strong>Methods:</strong> This was a prospective follow up study conducted in Rajarajeshwari Medical College and Hospital Bangalore, over a period of 14 months from June 2015 to August 2016. A total number of 60 patients who underwent unilateral primary total knee replacement were included for this study. They were randomly divided into 2 groups. Group I patients infused (intravenous) with 20 mg/kg TXA before incision and 3 hours after surgery whereas no TXA was administered in Group II. Total blood loss and transfusion rate were used as outcome. <strong></strong></p><p class="abstract"><strong>Results:</strong> Mean amounts of blood loss were 578 ml in Group 1 and 946 ml in Group 2. There was a decrease in blood loss in TXA groups (p&lt;0.001). Transfusion was required in 6 patients of Group I and 17 patients of Group II (p&lt;0.001). No thromboembolic problem was seen in any patients.</p><p><strong>Conclusions:</strong> Since TXA decrease perioperative blood loss and lessen the need for blood transfusion significantly, without increasing thromboembolic events in TKR. We suggest using intravenous (IV) TXA in TKR. </p>

Background: Adhesive capsulitis is a debilitating disease in an otherwise healthy individual. Intra-articular corticosteroid injections offer a cost-effective, non-operative treatment option. However, it is currently unclear whether an ultrasound-guided injection relieves the symptoms of shoulder pain more effectively than if the injection was delivered landmark-guided. Methods: Eighty patients with adhesive capsulitis were randomized to two intervention groups - landmark guided and ultrasound (USG) guided. The functional status of the patients was documented prior to the intervention. Following allocation, the intra-articular steroid was administered either under USG guidance or following identification of the site of injection using landmarks. Follow-up was done on day 5, 3 weeks, 6 weeks, and 12 weeks post procedure to document the functional status. Results: The difference in visual analogue score (VAS) between the two arms was found to be statistically significant in favour of the ultrasound guided technique only on day 5 and day 21. On the other hand, the difference in disability of arm, shoulder, and hand (DASH) score between the 2 arms was found to be statistically significant in favour of the ultrasound guided technique on day 5, 21, 42 and 84. Finally, in our study, both shoulder flexion and abduction on day 84 achieved a statistically significant improvement, favouring the ultrasound guided arm. Conclusions: Ultrasound guided corticosteroid injections may offer modestly better short-term functional outcome and symptom relief when compared with landmark guided corticosteroids.