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1.  Greater Omental Pancake Tumour due to Metastasis of Ovarian Cancer – A Cadaveric Study 
Cancer of ovary is the one of the common of all gynecological tumors and is the leading cause of death among women. A unique attempt is made to trace masses & its causes found in an abdomen of female cadaver during routine anatomy dissection.
The mass was thick, hard and somewhat nodular in the region of greater omentum, After dissecting the pelvic cavity, it was found that both the ovaries were bulky, nodular & hard. Whole abdominal cavity was dissected & found that liver also involved by metastasis.
Case suggests that there is the development of metastatic omental mass from grade IV ovarian cancer. Primary human omental adipocytes promote homing, migration and invasion of ovarian cancer cells. Adipokines like interleukin-8 (IL-8) mediate these activities.
PMCID: PMC3939527  PMID: 24596747
Cadaver; Greater omentum; Metastasis; Ovarian cancer ligament
2.  A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital 
Background: Psychiatric disorders are one of the major causes of morbidity. Development of newer drugs like SSRIs and atypical antipsychotics has altered the treatment paradigms. Various factors like cost of drugs, local paradigms, etc. play a role in the selection of drug therapy and hence, affect the outcome. Keeping this in mind, we conducted a study to delineate the various drugs used in psychiatric disorders, to find discrepancies, if any, between the actual and the ideal prescribing pattern of psychotropic drugs and to conduct a cost analysis.
Material and Methods: After our institutional ethics committee approved, a retrospective cross sectional drug utilization study of 600 prescriptions was undertaken. Preparation of the protocol and conduct of the study was as per the WHO – DUS and the STROBE guidelines.
Results: Drug use indicators – In 600 prescriptions, 1074 (88.25%) were psychotropic drugs. The utilization from the National and WHO EML was 100% and 90%, respectively. Average number of psychotropic drugs per prescription was 1.79 ± 1.02 (SD). 22.5% of the prescriptions contained psychotropic FDCs. 76.01% of drugs were prescribed by generic name. Percentage of psychotropic drugs prescribed from the hospital drug schedule and psychotropic drugs actually dispensed from the hospital drug store were 73.1% and 62.3%, respectively.
Drug utilization pattern in different psychiatric disorders – Most commonly prescribed drugs for schizophrenia, bipolar disorders, depression and anxiety disorders were trifluoperazine + trihexiphenydyl (63.9%), carbamazepine (17.2%), amitriptyline (34.9%), and diazepam (23.8%), respectively. The least commonly prescribed drugs were levosulpiride (1.7%), lithium (1.3%), bupropion (4.7%) and clozapine (1.9%), respectively. The PDD/DDD ratio of three drugs – haloperidol, pimozide and amitriptyline – was equal to one. The cost borne by the hospital was 116, i.e., 65.2% of the total cost. The cost index of clozapine was 11.2.
Conclusion: Overall, the principles of rational prescribing were followed. The hospital drug schedule should include more SSRIs. The practice of using 1st generation/ typical anti–psychotics as the first line was as per current recommendations. Anti–cholinergics should be used only in selected cases of patients on anti–psychotics. The use of diazepam should be curtailed and it should be used for short term only.
PMCID: PMC3919294  PMID: 24551631
Drug Utilization; Psychopharmacology; ATC; DDD; PDD
3.  Light at the end of the tunnel?: The Great Indian Pharmacoeconomics story 
PMCID: PMC3862112  PMID: 24379781
pharmacoeconomics; drug costs; drug price control; inflation; out of pocket expenditure
4.  The concept of: Generic drugs and patented drugs vs. brand name drugs and non-proprietary (generic) name drugs 
PMCID: PMC3770914  PMID: 24062686
generic drugs; international non-proprietary name; pharmacoeconomics; generic name; drug costs; bioequivalence studies
5.  MRI manifestations of soft-tissue haemangiomas and accompanying reactive bone changes 
The British Journal of Radiology  2011;84(1008):1100-1108.
Soft tissue haemangiomas are common benign vascular lesions that can be accompanied by reactive changes in the adjacent bone structure. This study aimed to discuss the MRI features of soft-tissue haemangiomas with an emphasis on changes in bone.
The radiographic and MRI findings of 23 patients (9 males, 14 females; mean age 25 years; age range 2–46 years) with soft-tissue haemangiomas were analysed retrospectively. MR images were evaluated for location of the lesion, size, configuration, signal features, contrast patterns, proximity to adjacent bone and changes in the accompanying bone. Excisional biopsy was performed in 15 patients.
Radiographs demonstrated phleboliths in 8 patients (34%) and reactive bone changes in 4 (19%). On MRI, T1 weighted images showed that most of the lesions were isointense or isohyperintense, as compared with muscle tissue; however, on T2 weighted images all lesions appeared as hyperintense. Following intravenous gadolinium-diethylene triamine pentaacetic acid (DTPA) administration, homogeneous enhancement was observed in 3 lesions and heterogeneous enhancement was seen in 19. No enhancement was observed in one patient. Bone atrophy adjacent to the lesion was observed in four patients.
MRI is the most valuable means of diagnosing deep soft-tissue haemangiomas. Bone changes can accompany deeply situated haemangiomas; in four of our patients, we found atrophy of the bone adjacent to the lesion. To our knowledge, this is the first report in the literature regarding atrophy of the bone adjacent to a lesion.
PMCID: PMC3473825  PMID: 21123304

Results 1-5 (5)