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To assess the utilization and evaluation of antimicrobial agents in a tertiary care teaching hospital. A prospective observational study was conducted for a period of 6 months. Data of our study was collected on the basis of inclusion and exclusion criteria. During the study period, 312 patients were covered, females (168) were receiving more antimicrobial agents (AMA) compared to males (144) and particularly the age group belongs to 36-50 years (35%) and average duration of stay in the hospital was 6.08 days. AMA's were most commonly received by respiratory disorder patients (24%) and renal disorder patients (15%). Commonly prescribed antimicrobials were ceftriaxone 180 (22.86%) and metronidazole 136 (16.75%). In antimicrobials class, antibiotics (523) were more prescribed followed by anti protozoal (136). Combinations of antibiotics were ceftriaxone + salbactum (45%) and piperacillin + tazobactum (22%) were mostly prescribed. In dosage forms, injections and tablets were more prescribed. Citrobacter species was the mostly isolated organism in many culture and sensitivity tests, it was showing resistance to doxycycline and norfloxicin as well as sensitivity to amikacin and nitrofurantoin. The rational use of AMAs is one of the main contributors to control worldwide emergence of antibacterial resistance. Clinical pharmacist and Clinicians need to play vital role in minimizing the antimicrobials problems by conducting continuous awareness programs regarding up-to-date prescribing guidelines in the hospital and also minimizing the antimicrobial resistance. Key Words:-Antimicrobial agents, Utilization, Sensitivity and Resistance, Cephalosporins, Ceftriaxone.

The aim of this study is to provide patient counseling among the COPD patients and assess its impact. This prospective questionnaire based study conducted for the period of 6 months among COPD patients. The data collected from 146 enrolled subjects with the help of questionnaire, appropriate patient counseling by providing patient information leaflets and followed by the assessment with the help of feedback form. Majority of patients were male n=108 (74%), and female were n=38 (26%). The occurrence was higher in age group of 61-80yrs n=79 (54%). COPD with co-morbidities were n=93(63%). Among 146 subjects n=78(53%) were smokers and n=68(46%) were non-smokers. Patients’ symptoms, physical & psychological status severity have been assessed by the help of using the CCQ (Clinical COPD Questionnaire). This study reveals that the impact of patient counseling among COPD patients were highly beneficial. Moreover, it was highly helpful to create the awareness about disease and medication management among the hospitalized COPD patients and can reduce the hospital stay. So, this study concluded that patient education is important and crucial for appropriate and comprehensive patient care. Key Words:-Counseling of COPD, Impact of Counseling, Quality of Life, COPD.

Objective: To evaluate the medication adherence in Type 2 Diabetes Mellitus and factors influencing its non-adherence. Background: Patient adherence to prescribed therapies in type 2 diabetes mellitus (T2DM) is an area of enormous importance because of the strong correlations between adherence, patient outcomes, and treatment costs. In T2DM, nonadherence to regimens may compromise glycemic control, which can, in turn increase morbidity and mortality rates. Method: A literature search was performed to identify studies reporting adherence to anti-diabetic medications and highlighting the factors affecting its non-adherence. The search was limited to RCTs written in English with a freely available abstract. Data sources: PubMed (2013-2018). Review methods: Studies which are not reporting adherence to medications or highlighting factors associated with its non-adherence in T2DM, and those with gestational diabetes and type I diabetes were excluded. Eligible reports are discussed narratively. Results: Low adherent patients constituted majority of the study population in all the included studies. The major determinants of non adherence were found to be age, duration of therapy, educational status, cost of medications, knowledge and complexity of medication regimen. Conclusion: Medication adherence is influenced by multifactorial issues and they have a detrimental impact on the quality of life of patients. We recommend that adoption of certain interventions like improving interactions with patients, reducing the complexity of medication regimen, educational initiatives, reminder systems and reduced costs may result in the desired patient outcome which is euglycemia. Key Words:- Type 2 Diabetes Mellitus; Medication Adherence; Factors; Medication Non- Adherence.

Cancer is a disease which affects not only patients but also their families physically and emotionally. The purpose of the study was to determine the psycho-social aspects like depression, anxiety, stress, etc., in cancer patients. In this study, a cross sectional approach was used. Data were collected through individual interview by using well designed questionnaire after obtaining proper consent. The study sample comprised of 243 patients. The study findings are grouped under age, gender, and psycho-social aspects such as financial hardship, stress, depression, loss of appearance, loss of interest in usual activities, disease knowledge and its prevention, out of 243 study population 120 were females and 123 were males. Among 243 study population 161 patients were majorly stressed, 66 patients were moderately stressed and 17 patients were suffering from minor stress. Psycho-social aspects in which patients were suffering majorly with stress 74.89%, depression 83.9%, financial hardship 79.83% and misconceptions 52.12%. In our study out of 243 patients, majority of the cancer patients (66.2%) were suffering with psycho-social distress and 77.3% patients were relieved from the distress after obtaining counselling.

Key Words:-Psycho-social aspects, distress, cancer, impact of psycho-social aspects, psycho-oncology.

The liver performs a vital role in metabolism, secretion, storage and detoxification of endogenous substances. There is a lack of reliable hepatoprotective drug in modern medicine to prevent and treat drug- induced liver damage. The aim of the study is to evaluate the hepatoprotective activity of Phyllanthus emblica (Phyllanthaceae) against paracetamol induced liver damage in wistar rats. The rats were divided into five groups(I to V) each group consisting of six animals. Group I animal is normal. Group II was treated with paracetamol (400mg/KgP.O). Group III, Group IV and Group V were treated with paracetamol + silymarin(200mg/KgP.O), Paracetamol + Low dose of MNK (dose 1) P.O and Paracetamol + High dose of MNK (dose 2)P.O respectively for seven days. On eighth day, the blood is collected through retro-orbital plexus and liver antioxidant enzymes were estimated by assessing the Alanine aminotransferase(ALT), Alkaline Phosphate (ALP) and Aspartate aminotransferase(ALP). The results obtained were effective and hence Phyllanthus emblica shows significant of hepatoprotective activity

Transient hypocalcemia is a frequent complication after total thyroidectomy. Routine postoperative administration of
vitamin D and calcium can reduce the incidence of symptomatic postoperative hypocalcemia It has been hypothesized that
there is a relationship between underlying vitamin D deficiency and the risk of post-operative hypocalcemia. We performed
a cross-sectional review on 50 thyroidectomies from SLIMS hospital. Pre-operative vitamin D levels and post-operative
calcium level were obtained. The incidence of hypocalcemic symptoms was studied. Biochemical hypocalcemia was
defined as any single post-operative corrected calcium level < 8.0 mg/dl (to convert to millimoles per liter, multiply by
0.25). There was a significant differentiation between mean of vitamin D levels in hypocalcemic group and normocalcemic
group. The results of this study indicate that routine pre and post TT calcium and Vitamin D supplementation can
significantly reduce post operative hypocalcemia. We, therefore, suggest the same in the prevention of post TT
hypocalcemia, which ultimately can also decrease prolonged hospitalization of patients and costs associated with multiple
blood sampling. Patient with lower vitamin D levels should benefit from a screening for post-operative hypocalcemia. Preoperative vitamin D levels appear to have a significant effect on the risk of post-thyroidectomy hypocalcemia