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Dermatomyositis is an inflammatory myopathic disease which is characterized by chronic muscle inflammation
accompanied by muscular weakness. The prevalence rate of dermatomyositis is 1 in 10,00,000 population with high risk in
females than males. Interstitial lung disease is the most common and severe complication of inflammatory muscle diseases
like dermatomyositis that affect the tissue and spaces around alveoli. In these patients, muscle weakness is usually
accompanied by shortness of breath and cough and can lead to severe respiratory distress. We report a case of a male
patient, 45 years old whose clinical history was onset in March 2019 with classical muscular weakness, heliotrope rash,
gottron’s papule and respiratory symptoms like cough and shortness of breath. Patients was on steroids and
cyclophosphamide therapy. In this brief case report, we want to emphasize on the pulmonary complication of
dermatomyositis

The association between depression, fibromyalgia suggests that they divide the model of developmental
traumatology. This study aimed at presenting a case of depressive disorder and fibromyalgia as well as at discussing causes
and consequences of both diagnoses. Here a 36 year old female patient, with fibromyalgia and depressive disorder, current
severe episode, without psychotic symptoms, with no somatic symptoms for approximately six months. History of stressing
events with loss of affective relationship problems is present. Early life stress may be the causal factor of painful symptoms
in depression and fibromyalgia

Myelin oligodendrocyte glycoprotein (MOG) is a regulatory glycoprotein involved in microtubule stability of
myelin surface. Optic neuritis is an inflammatory condition of optic nerve, caused by damage and loss of protective sheath
(myelin) surrounding the optic nerve which is so vital for good vision. Aquaporin-4 (AQP-4) will be negative for patients
with MOG antibodies associated optic neuritis. This is a case of 39 years old male patient with complaints of diminished
vision in left eye followed by right eye since 1 month, which is gradually in onset and progressed within 5 days. MRI scan
of dorsal spine showed T3 –T11 hyper intensity in retrobulbar region and MRI with contrast study showed altered signal
intensity in cervical and dorsal spinal cord with patchy enhancement suspicious of demyelination. Serum analysis shows
presence of anti-MOG IgG antibodies. Due to the poor prognosis of the disease, patient was advised to be in observation for
15 days and planned for 2 doses of Rituximab 500 mg. Meanwhile, symptomatic treatment was also given. This case implies
that the early diagnosis of MOG-antibodies can differentiate the demyelination from AQP-4 antibodies positive
demyelination and can treat accordingly. It is necessary to test patients longitudinally to assess the anti-MOG serostatus.
Rehabilitative care is needed to prevent secondary complications of immobility and to improve functional status

Objective: A study on rational use of antibiotic for pre and post-surgical management. Methods: prospective clinical
observational study was conducted from a period of six months. Data of our study was collected on the basis of inclusion
and exclusion criteria. Data collection forms are used for data entry and analysis after ethical clearance for our study. During
the study period, 223 patients were covered, males(152) were receiving more antibiotics compared to females(71) and
particularly the age group belongs to 51-70years. Commonly complaining surgical conditions were Appendicitis(22.87%)
and Hernia(19.73%) and receiving more antibiotics. Commonly prescribed antibiotics were Cefotaxime155(34.91%) and
metronidazole 134(30.18%) in the prescription. Combination antibiotics were Amoxicillin+clavulanic acid (48.73%) and
Pipercillin+Tazobactam(46.15%) were mostly prescribed. In dosage forms injection and tablets were more prescribed.
Patient who stay in hospital about <5 days are 113 patients(50.67%), about 5 days are 25 patients(11.21%) and >5days are
85 patients(38.17%).Conclusion: In our study 444 antibiotics were analyzed and it was found that the most commonly
prescribed antibiotic in surgical department was Cefotaxime. The most commonly complaining case in our hospital was
Appendicitis. Antibiotic prescription was rational regarding their dose, frequency, time of administration and indication.
Clinical pharmacist and clinicians need to play vital role in minimizing the antibiotic associated problems by conducting
continuous awareness programs regarding up-to-date prescribing guidelines in the hospital and also can contribute for
minimizing the antibiotic resistance

The Aim of the study is to observe the prescription pattern of Antihypertensive's among CKD patients with or without co-morbidities. A Prospective observational study was conducted for period of 6 months at VIMS hospital, Bellary, Karnataka. Data collected from 150 enrolled subjects from patients profile sheets. A total of 150 patients were enrolled in this study. Majority of patients were Male n=105 (70%), and Female were n=45 (30%). The occurrence was higher in age group between 40-69 years n=105 (70%). CKD with co-morbidities were n=98 ( 65.3% ),among them 70 were Male (71.4%) and 28 were Females (28.6%).Among 150 patients 52 patients were diagnosed as CKD, among them 35(67.30%) were Male and 17(32.70%) were Female. The study reveals about the prescription pattern monitoring of Antihypertensive in CKD population. The study concluded that prescription pattern monitoring plays vital role to find out rational and irrational use of drugs and to improve patients quality of life and clinical pharmacist also plays the crucial role in the chronic diseases thereby, prescription pattern monitoring studies helps to observe drug interactions, duplication of the drugs and irrationalities. Therefore, PPM studies helps to select the appropriate choice of drugs based on the standard treatment guidelines to promote the rational use of medicines. Moreover, this kind of studies is helpful to the health care professionals to provide the quality treatment for the benefit of patients. Prescription pattern observed and it has not deviated from the KDIGO guidelines.

Drug Utilization Review is an authorised, structured, ongoing review of prescribing, dispensing and usage of
medication before, current and after the therapy. Cephalosporins are among the most commonly used class of antibiotics in
hospitals and healthcare facilities world-wide and the use of newer generation of cephalosporins have increased in the
developed countries with limited number of studies investigating the drug prescribing and utilization pattern in the hospital
setting. Hence the present study was carried out aiming to systematically evaluate and review the prescribing patterns of
various cephalosporins in general medicine department in a tertiary care teaching hospital at Gujarat. A prospective
observational drug utilization study was carried out for a period of 6 months. A total of 110 patients enrolled in the study
from general medicine department in tertiary care hospital. The data were evaluated for use of cephalosporins with their
safety outcomes. The data‟s were collected using specially designed patient data collection form and the appropriateness is
assessed with the help of NICE guidelines.Cephalosporins are empirically prescribed in the general medicine department.
Male patients accounted for (59%) and female patients were (41%). Majority of study population prescribed with third
generation 94% followed by second generation 3% as primary treatment. Majority of cephalosporins were prescribed in
injection form (89.83%). The present study concludes that out of 110 patients, most patients hospitalized with infection and
followed by other disease conditions. Mostly third generations cephalosporins were used to treat in various conditions in
general medicine ward. Mostly parenteral route was prescribed based on the conditions. It shows that the cephalosporins are
appropriately prescribed according to the guidelines

Introduction: Community screening method such as IDRS increases the public awareness and highlights the seriousness of
the disease and could help in identifying asymptomatic individuals, who can ultimately be brought into management and can
modify the course and complication of diabetes. In fact, their diagnosis is often delayed until the development of
complications or disease is diagnosed incidentally by a health professional. Therefore, early diagnosis of diabetes mellitus
could favor the implementation of preventive measures aimed at preventing complications associated with diabetes mellitus.
Aims & objectives: The present study aimed to identify individuals at risk for diabetes, in a community setting, using the
IDRS. Study methodology: A cross sectional study was under taken to evaluate the performance of Indian diabetic risk
score among adult population in community setting located in Vijayawada, Andhra Pradesh (India). The participants were
fully informed regarding the purpose of the study. The patient information sheet was explained to each subject and written
consent was obtained. Each interview began with a general discussion to build rapport with the participants to gain their
confidence. Results: Out of 381 participants, the majority of participants (181; 47.5%) were in the high-risk category
(IDRS>60), 164(43%) were at moderate risk score (IDRS 30-50), and 36(9.44%) participants were found to be at low risk
for diabetes (IDRS <30). Of all the participants, 182 (47.7%) participants were male and 199 (49.3%) were female. In high
risk category, male 96(52.7) participants were more compared to females 85 (42.7%) while under moderate risk catergory,
female participants 90(45.2) were more than males 74(40.6). Similarly, female 24(12.06) participants were more than males
12 (6.5) in low risk category. Conclusion: The Indian diabetes risk score is highly sensitive test for early diagnosis of prediabetes, and if screening is done in the pre-diabetic stage then we can prevent it into conversion in diabetes mellitus and
late diabetic complications in Indian community. The IDRS was a simple tool used in a community-based study to detect
individuals at high risk for diabetes. Non-modifiable risk factors like increasing age and family history of diabetes, and
modifiable risk factors like lack of physical activity and central obesity were the most common factors found in participants
who were at high risk for diabetes. So we conclude that the risk of diabetes can be reduced by the change in modifiable
factors in high risk population and also reduced by decreasing the waist to hip ratio