TO STUDY THE USE OF GUIDELINES IN STATINS PRESCRIPTION AT TERTIARY CARE CENTRE OF NORTH INDIA

Background: To study the use of guidelines in statins prescription at tertiary care centre of North India Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD,Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: In our study, 81.9% of total study population were receiving statins according to guideline and 18.1% were receiving statins not according to guideline. In the primary prevention group,91(83.5%) patients were receiving statins according to guideline and 18(16.5%) were receiving not according to guideline. In the secondary prevention group, 108(80.6%) patients were receiving statins according to guideline and 26(19.4%) patients were receiving statins not according to guideline. Concluded: In our study, more than two third of patients in our study were receiving prescriptions according to guideline Keywords: Statin, Guideline, Use

TO EVALUATE EFFICACY OF LAPAROSCOPIC TRANSPERITONEAL PYELOLITHOTOMY FOR MANAGEMENT OF RENAL PELVIC STONES IN TERM OF POSTOPERATIVE HOSPITAL STAY

Background: To evaluate efficacy of laparoscopic transperitoneal pyelolithotomy for management of renal pelvic stones in term of postoperative hospital stay Methods: This study has been conducted in the Department of General surgery, Indira Gandhi Medical College, Shimla on selected patients of Renal pelvis stones admitted in institution Results: Mean hospital stay was 6.66 days in laparoscopic group and it was 8 days in laparoscopic completed by open method. Maximum no. of patients was discharged within 5 days. 6 (75 %) patients returned to normal activity in less than 30 days which included only successful laparoscopic group and 2 patients returned to normal activity in 40 days which included lap completed by open group. Conclusion: In the present study of Laparoscopic Transperitoneal Pyelolithotomy at Indira Gandhi Medical College, Shimla, the procedure showed a definite decrease hospital stay, early return to activity than who have undergone open surgery Keywords: Laparoscopic Transperitoneal Pyelolithotomy, Pelvic stone, Hospital stay.

STUDY OF OUTCOME OF STATIN THERAPY IN PATIENTS BY CHECKING LIPID PROFILE AFTER 3 MONTHS OF STARTING TREATMENT IN STATIN NAIVE PATIENTS

Background: To describe the outcome of statin therapy in patients by checking lipid profile after 3 months of starting treatment in statin naive patients Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD, Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: The mean decrease in total cholesterol, triglycerides, VLDL and LDL levels in primary prevention group mean decrease in after 3 months of statin treatment in comparison to baseline were 17.24%,21.24%, 22.83 % and 33.19% respectively and increase in mean HDL level was 9.55%. The mean decrease in total cholesterol, triglyceride, VLDL and LDL levels in secondary prevention group after 3 months of statin treatment in comparison to baseline were 14.35% 15.80%, 16.17% and 36.92% respectively and increase in mean HDL level was 8.77%. Concluded: So there was statistically significant change in lipid profile from baseline in both primary and secondary prevention groups after 3 months of statin treatment. Keywords: Statin, LDL,VLDL, HDL

TO EVALUATE COMPLICATION OF LAPAROSCOPIC TRANSPERITONEAL PYELOLITHOTOMY FOR MANAGEMENT OF RENAL PELVIC STONES

Background: To evaluate complication of laparoscopic transperitoneal pyelolithotomy for management of renal pelvic stones Methods: This study has been conducted in the Department of General surgery, Indira Gandhi Medical College, Shimla on selected patients of Renal pelvis stones admitted in institution Results: There were no major postoperative complications. Two patient developed mild low grade fever which subsided on oral antipyretic medication. One patient had a cough and one patient had ileus. Conclusion: We concluded that there were no major intraoperative or postoperative complications were seen in our study. Keywords: Laparoscopic Transperitoneal Pyelolithotomy, Pelvic stone, Complication

STUDY REGARDING ETHICAL VERSUS GENERIC PRESCRIPTION OF STATINS

Background: To study the ethical versus generic prescription of statins Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD,Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: In our study population, amongst the primary prevention group, a larger percentage about 56% were receiving generic prescription of statins and about 44% were receiving ethical prescription of statins .Whereas in secondary prevention group, about 45.5% of patients were receiving generic prescription and 54.5% were receiving ethical prescription . Concluded: In our study population patients were equally prescribed on ethical (49.8%) and generic prescriptions (50.2%). Keywords: Statin, Ethical, Generic

TO EVALUATE EFFICACY OF LAPAROSCOPIC TRANSPERITONEAL PYELOLITHOTOMY FOR MANAGEMENT OF RENAL PELVIC STONES IN TERM OF BLOOD LOSS

Background: To evaluate efficacy of laparoscopic transperitoneal pyelolithotomy for management of renal pelvic stones in term of blood loss Methods: This study has been conducted in the Department of General surgery, Indira Gandhi Medical College, Shimla on selected patients of Renal pelvis stones admitted in institution Results: Mean blood loss in successful laparoscopic surgery was 58.33 ml and in lap converted to open was 200 ml. Conclusion: Laparoscopic pyelolithotomy is a feasible and safe operation for patients with renal stones in centers with adequate experience in laparoscopy and well trained surgeons. It is found to be safe, effective and efficient with proper patient selection and adherence to standard laparoscopic surgical principles. Keywords: Laparoscopic Transperitoneal Pyelolithotomy, Pelvic stone, Blood loss

PATTERNS OF PRESCRIPTION OF STATINS IN A TERTIARY CARE CENTRE OF NORTH INDIA

Background: To study the pattern of prescription of statins in a tertiary care centre. Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD, Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: Atorvastatin was found to be more commonly prescribed (n=179), which is about73.7%compared to Rosuvastatin (n=64) which is about 26.3%. In our study, 75 (68.8%)patients of primary prevention group and 104(77.6%) patients of secondary prevention group were receiving Atorvastatin and 34 (31.2%) patients of primary prevention group and 30(22.4%)patients of secondary prevention were receiving Rosuvastatin on their prescription. Concluded: In our study, there were prescriptions with only Atorvastatin and Rosuvastatin. No prescription with other statins was found. Atorvastatin was being more commonly prescribed to rosuvastatin. Keywords: Statin, Atorvastatin, Rosuvastatin

INDICATIONS OF PRESCRIPTION OF STATINS IN TERTIARY CARE CENTRE OF NORTH INDIA

Background: To determine the indications for which statins are being prescribed Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD,Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: In our study, out of 243 prescriptions, 55.1%(n=134) were prescribed statins for secondary prevention and 44.9%(n=109) had statins prescribed for primary prevention. Overall coronary artery disease (37.03%) was the leading indication followed by Diabetes mellitus without ASCVD(70.64%).Other indications of secondary preventionincluded newly diagnosed statin naïve patients diagnosed with stable coronary artery disease ,unstable coronary artery disease /acute coronary artery disease , ischemic cardiovascular accidentsand peripheral arterial disease .64.22 percent patients in primary prevention group were diabetics in our study . Concluded: We concluded that secondary prevention was found to the more common indication of statin prescription than primary prevention (ratio 1.22:1). Keywords: Statin, CAD, Prevention

BEDSIDE LAPAROSCOPY AS DIAGNOSTIC TOOL REVIEW OF ABDOMINAL PATHOLOGIES IN CRITICALLY ILL PATIENTS: REVIEW

Introduction: The diagnosis of abdominal pathologies in critically ill patients is often difficult because of inconclusive laboratory tests or imaging results, or the inability to safely transfer a patient to the radiology room. These causes give a delayed diagnosis of abdominal pathology in the intensive care unit (ICU) and increase rate of morbidity and mortality. The aim of this retrospective study is to evaluate the safety and diagnostic accuracy of bedside diagnostic laparoscopy in the identification of intra-abdominal pathology in critically ill patients. Aim: The aim of this retrospective study is to evaluate the safety and diagnostic accuracy of bedside diagnostic laparoscopy in the identification of intra-abdominal pathology in critically ill patients. Materials and Methods: A literature research was carried out including PubMed, Medline, Embase, Cochrane and Google Scholar databases to identify articles reporting on importance of diagnostic accuracy of bedside diagnostic laparoscopy in the identification of intra-abdominal pathology in critically ill patients. Conclusions: Bedside diagnostic laparoscopy represents a safe and accurate technique for diagnosing intraabdominal pathology in an ICU setting and should be taken into consideration when patient transfer to radiology or the operating room is considered unsafe or when routine radiological examinations are not conclusive enough to reach a definite diagnosis. Keywords: Bedside laparoscopy, critically ill patients, ultrasonography (US), computed tomography (CT) , emergency surgery

COMPARATIVE STUDY OF PLATELET COUNT IN DIABETIC AND NON-DIABETIC GERIATRIC POPULATION

Geriatric population (> 60 years) is rapidly increasing in India, It has been increased upto 8.6% in 2011. Diabetes Mellitus (DM) is a metabolic disorder and a major health problem, a?ecting a large section of the Indian population, especially as its incidence increases with advancing age. Host of complications are associated with this disease, one of which is the e?ect on platelet count. This study compares platelet count between diabetic and non-diabetic elderly. It is observed that Hyperglycaemia in diabetic persons is responsible for increased Thrombopoietin production at the cellular level, which leads to raised platelet count -Reticulated Thrombocytosis – when compared to non diabetics. Platelets, especiallyreticulated thrombocytes are associated with uncontrolled blood sugar levels in the body and are well known for their role in artherosclerotic cardiovascular disease (CVD). Keywords: platelet count, diabetic and non-diabetic & geriatric.