Objectives:Continuous availability of affordable medicines in appropriate formulations is essential to reduce morbidity and mortality in children. Odisha an eastern Indian state records very high mortality of children. The study aims at documenting the availability and prices paid for purchasing essential child-specific medicines.Materials and Methods:The survey of 34 essential medicines was conducted in six randomly selected districts of Odisha. Data were collected from medicine outlets of the public, private, and other sector (Nongovernmental Organization [NGO]/mission sectors) of six randomly selected districts, using WHO/Health Action International medicine price collection methodology. For each medicine surveyed, data were collected on the highest and lowest-priced formulations available in each facility.Results:Both public sector and other sector health facilities procure only one brand of medicines, mean percentage availability of medicines being 17% and 21.8%, respectively. In the private sector, the mean percentage availability of the high and lowest-priced medicines for a particular drug product was 10.8% and 38.5%, respectively. The public sector procurement price is 48% lower than international reference prices. In the private sector, high-priced, and low-priced products are sold at 1.83 and 1.46 times the international reference price, respectively. Substantial price variation was observed for some medicines across individual outlets. Medicines were found to cost 2.08 times their international reference price in NGO/mission sector facilities.Conclusions:The availability of children's medicines in public sector facilities of Odisha state is poor. Medicines for children cost relatively high in both private and NGO sectors compared to the international reference price. The availability medicines should be improved on an urgent basis to improve access of medicines for children of Odisha.

Background: Study of pattern of benign breast disease is a challenge due to variants in occurrence and presentation in different age groups and different geographical areas. The objective was to study the pattern of benign breast diseases and its clinical, pathological and radiological correlation.Methods: This is a prospective study of females with benign breast diseases presenting to surgery department. This work was done for studying the age distribution, to evaluate the different types of benign diseases of the breast, their mode of clinical presentation, pathology, to evaluate the accuracy of different modes of triple assessment and various modes of management for different types of Benign Breast Diseases. Patients with obvious malignancy and males were excluded from the study.Results: A total of 200 females were included in the study. Fibroadenoma (55%) was the commonest diseases with presenting mostly at 20-24years of age. Clinical examination had accuracy of 88%, USG had accuracy of 77.3%, FNAC had 93% and mammography had 83.33% accuracy foe diagnosing benign breast diseases.Conclusions: Benign breast diseases are common problems of 2nd and 3rd decade in females and raises considerable fear of malignancy. The patients of BBDs generally present with one or more of these complaints-breast lump, breast pain or nipple discharge. All the patients with discrete breast lumps should undergo a triple assessment to make an early diagnosis.

A right atrial myxoma extending to the inferior vena cava with associated right-to-left shunting leading to systemic desaturation is an exceedingly rare clinical entity. The number of cases reported in the literature to date is not more than five. This case study presents a 45-year-old female who was referred to our center with symptoms of breathlessness, easy fatigability, generalized weakness, and central cyanosis. On routine blood investigation, polycythemia was detected. On preoperative 2D-transthoracic echocardiography, the diagnosis of right atrial mass was confirmed but the reason for cyanosis was not revealed. A tumor thrombus in a branch of the right lower pulmonary artery with a small locoregional pulmonary infarct along with right atrial myxoma was reported in computed tomography angiography of the heart and great vessels. On-table transesophageal echocardiography showed patent foramen ovale (PFO) with right-to-left shunting because of raised right atrial pressure and dynamic obstruction of the tricuspid valve by the mass. The myxoma was resected completely via right atrial approach along with primary closure of PFO. Postoperative period was uneventful, and the patient was discharged on day seven. At three-month follow-up, the patient was doing well.

Background: Urinary tract infection (UTI) is a common illness affecting both males and females in almost all age groups. Varieties of antimicrobials such as cotrimoxazole, nitrofurantoin, fluoroquinolones, and penicillin are effective for treatment of UTI. Aims and Objectives: The present observational study was planned to generate data on antimicrobial use pattern in UTI which could be beneficial in selection of rational drug therapy in UTI. Materials and Methods: The retrospective study was carried out by analyzing indoor and outpatient department case records of UTI patients of a tertiary care hospital. The demographic data and prescription pattern, urine culture report, along with the antimicrobial sensitivity testing were evaluated. The data were analyzed by routine descriptive statistics. Results: Escherichia coli was the most common organism to be isolated in urine culture followed by Staphylococcus aureus. Cephalosporin group was the most prescribed antibiotics in all age groups. Although nitrofurantoin and cotrimoxazole were showing good sensitivity pattern when compared with other antimicrobial groups, these were least prescribed. Conclusion: The choice of antimicrobial drugs should be individualized based on patient compliance, adverse effects, availability and costing factors, along with prevailing sensitivity pattern in the locality. Nitrofurantoin can be better alternative for uncomplicated UTI when compared to third generation cephalosporins.

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