Diabetic nephropathy is a leading cause of end stage renal disease. Drug utilization studies could promote rational drug use. The objective of this study was to evaluate prescribing trends in hospitalized patients with diabetic nephropathy. A prospective, observational study was conducted in a tertiary care hospital. The demographic, disease and treatment data of patients with diabetic nephropathy were collected for a period of six months and analysed. Drugs were classified using World Health Organization recommended Anatomic Therapeutic Chemical classification. A total of 755 drugs (7.4 drugs per prescription) were prescribed to 102 study patients, who were all hypertensive and in late stages of diabetic nephropathy. Drug classes with largest representation were those acting on gastrointestinal tract plus metabolism (37%) and cardiovascular drugs (28%). Calcium channel blockers represented the largest antihypertensive drug class (41%). Almost three-fourths of patients received more than one antihypertensive agent. Approximately 37% of patients did not receive any antidiabetic medication. Of those who did, prescriptions for insulin (91%) exceeded those of oral hypoglycaemic drugs (9%). Antimicrobials accounted for 10.2% of all drugs prescribed, of which 31.8% were quinolones. Drugs prescribed by generic name accounted for 11.98%. While all patients received antihypertensive therapy, more than a third were not on any antidiabetic treatment. Antihypertensive poly-therapy was observed in the majority with calcium channel blockers being most frequently prescribed antihypertensive drug class. Insulin was the preferred to hypoglycaemic drugs.

The EAA clinical study provides a quantitative basis for the safety indicators' in AF listed in the NHS Commissioning Support Document and emphasises the importance of the document.

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$26.95 (softcover).Emergency Medicine is intended as a study aid for those preparing for the U.S. Medical Licensing Examination (USMLE) Steps 2 and 3. The book contains 500 questions followed by explanations for both correct and incorrect answers. It covers the wide breadth of emergency medicine topics, including chest pain and cardiac dysrhythmias, trauma, altered mental status, shock and resuscitation, poisoning and overdoses, wound care, fever, and psychosocial disorders.The intent of this book is to simulate the format of the USMLE, in the question content, the complexity of the questions, and the time it takes to answer each question. It is a practice guide with clearly written and well-thought-out questions, followed by a short discussion of topics brought up by the question and answers. To simulate the time format, the reader is asked to allot 1 minute per question.The content and complexity of this textbook has met its goal of targeting medical students and junior residents. For example, in the altered mental status chapter, when faced with an young patient who has seized for the second time in 30 minutes, the student must decide the correct positioning of the patient, when and what therapy to administer first, and when to perform rapid-sequence intubation on the patient. The answers provided are concise and also reference textbooks, in case the reader desires further information.The limitations of this practice guide are few and are inherent in its style. Topics are not covered in their entirety. As such, one should not use this book to gain a complete understanding of, for example, inflammatory bowel disease. Rather, one should be able to identify and stabilize various emergency complaints and also be able to determine what should be the first step in elucidating the diagnosis and initiating treatment. Overall, Emergency Medicine successfully meets its goal as a targeted, yet comprehensive tool to be used in preparation for the USMLE.