Pharmacy practice is still in the initial stages of development in India, but the launching of Doctor of Pharmacy (PharmD) study program has brought serious discussions about clinical pharmacy in the country. As the profession is in a budding stage in the country, the patients, physicians, nurses, other healthcare providers, recruiters in pharmaceutical industries, prospective students, and their parents have numerous questions about this profession and study course. The objective of this article is to create awareness about clinical pharmacy services and to introduce the role of clinical pharmacists. After reading this article, one will know about the usefulness of clinical pharmacists in the Indian healthcare system against the current laws in the system. The article describes the role of Clinical pharmacist in the hospitals, and it also tells about the related myths and facts. A Pharm D person is an eligible to work in all areas where a Bachelor of Pharmacy (B. Pharm) qualified student can work. Apart from this, a clinical pharmacist (both Pharm D and M. Pharm Pharmacy Practice) can work in several other areas after completion of the course. Here, we are predicting the career prospectuses and job opportunities of Clinical Pharmacists according to the international scenario. Though all these areas are not well-established at present in India for clinical pharmacists, we believe that these areas would be open for them in near future. The article describes the role of clinical pharmacists in the hospitals, in research, in pharmaceutical/contract research companies, in community service and it also tells about the related myths and facts. Prospective job opportunities for clinical pharmacists, present challenges and the possible solutions are elaborated as well.

Neuroleptic malignant syndrome (NMS) is one of the serious complications of antipsychotics that occur rarely. Its prevalence is more commonly seen in individuals of age 20 to 40 years. Major etiology includes depletion of dopamine levels in central nervous system (CNS). It usually occurs, when high doses of antipsychotics are administered or sudden change in doses of antipsychotics or any withdrawal of anticholinergics abruptly. Sometimes, NMS follows withdrawal of dopaminergic medication in Parkinson’s patients. It is characterized by ‘lead pipe’ muscle rigidity, autonomic dysfunction, hyperthermia, extra pyramidal side effects. Clinical manifestations of NMS resemble malignant hyperthermia, serotonin syndrome, lethal catatonia and infectious disorders of CNS. NMS is a diagnosis of exclusion, thus differential diagnosis is of utmost important, by an expertise clinician. Laboratory findings that help in diagnosis are creatine phosphokinase (CPK) levels, leukocyte count, myoglobinuria and liver enzymes. Most lethal complication constitutes death, due to multi organ failure which accounts 10% to 20 % of renal and cardiovascular failure. Management comprises of prompt withdrawal of offending antipsychotic agent/neuroleptic drug after diagnosis, dopaminergic agonists are administered and supportive care is provided to the subject. A prompt medical attention is required as a consequence of high mortality. Thus, the treatment options were proposed to reduce the mortality due to NMS in clinical settings.

Neuroleptic malignant syndrome (NMS) is one of the serious complications of antipsychotics that occur rarely. Its prevalence is more commonly seen in individuals of age 20 to 40 years. Major etiology includes depletion of dopamine levels in central nervous system (CNS). It usually occurs, when high doses of antipsychotics are administered or sudden change in doses of antipsychotics or any withdrawal of anticholinergics abruptly. Sometimes, NMS follows withdrawal of dopaminergic medication in Parkinson’s patients. It is characterized by ‘lead pipe’ muscle rigidity, autonomic dysfunction, hyperthermia, extra pyramidal side effects. Clinical manifestations of NMS resemble malignant hyperthermia, serotonin syndrome, lethal catatonia and infectious disorders of CNS. NMS is a diagnosis of exclusion, thus differential diagnosis is of utmost important, by an expertise clinician. Laboratory findings that help in diagnosis are creatine phosphokinase (CPK) levels, leukocyte count, myoglobinuria and liver enzymes. Most lethal complication constitutes death, due to multi organ failure which accounts 10% to 20 % of renal and cardiovascular failure. Management comprises of prompt withdrawal of offending antipsychotic agent/neuroleptic drug after diagnosis, dopaminergic agonists are administered and supportive care is provided to the subject. A prompt medical attention is required as a consequence of high mortality. Thus, the treatment options were proposed to reduce the mortality due to NMS in clinical settings.

In an attempt our study was to assess health-related quality of life, anxiety & depression among patients with Rheumatoid arthritis. In this study demonstrates that the Rheumatoid arthritis patients evaluated were more likely to have lower Quality of Life, and high prevalence rates of depression and anxiety, the factors leading to an increased risk of depression among Rheumatoid arthritis patients included being female and older. As depression is the one of the major factor for medication non adherence ,So it could be better if Rheumatoid arthritis patients should be regularly assessed and should be monitored for accompanying anxiety and depression during follow-up, to achieve better therapeutic outcome, and to improve patient Quality of Life. We are taking Out of 50 patients, both men and women. It is a six months observational prospective cohort study conducted at King George Hospital, we have to assess the health-related quality of life in patients with RA along with Anxiety and depression in these who are patients suffering with Rheumatoid arthritis. In the data was collected from the direct patient-reported survey, and we are analysed the data by using the Microsoft excel spread sheet along with, Hamilton Rating Scale for Depression HAM-D, Hamilton Anxiety Rating Scale (HAM-A) and we are taken informed consent forms and with proper compliance and age greater than 18 years those who are positively diagnosed with rheumatoid arthritis.

Objective: The purpose of the present research study was to develop sustained release (SR) tablet formulations for Losartan Potassium using HPMCK100M as a release retardant. Methods: Losartan Potassium is an antihypertensive agent angiotensin-II receptor blocker belongs to BCS class-II agent. SR tablets for Losartan Potassium were formulated using variable quantities of HPMCK100M and Xanthan Gum by direct compression method. quantities of polymers was chosen as independent variables, X1 and X2 respectively whereas, time required for dissolution 10% (t10%), 50% (t50%), 75% (t75%) and 90% (t90%) of drug from formulation were chosen as dependent variables. 9 formulations were prepared and evaluated for various pharmacopoeial tests. Results: The results reveals that all formulations were found to be within the acceptable limits and release rate profiles of all formulations were fitted to kinetic models. The statistical parameters were determined. Polynomial equations were developed for dependent variables. Validity of them was checked by countercheck formulations (C1, C2). According to SUPAC guidelines, formulation (F4) containing mixture of 10% HPMCK100M and 14% Xanthan gum, was found to be identical formulation (dissimilarity factor f1= 1.765, similarity factor f2= 86.735) to marketed product (COZAAR). Conclusion: Formulation F4 follows First order kinetics, Non-Fickian Diffusion Anomalous Transport. (n= 0.825).

Combinatorial chemistry is one of the advanced method of synthesize the large number of molecules in short period of time. Synthesize the million number of same molecules are different molecules at a time. This method was fast and economic, then increase the competition between newer drugs in market. The present review describes that introduction about combinatorial chemistry, combinatorial library, techniques used in combinatorial chemistry and applications. Most commonly used combinatorial techniques are solid phase synthesis (in this technique resin beads, pins and chips are used as solid support, parallel synthesis, mixed combinatorial synthesis and solution phase synthesis. This technique was used in many areas such as pharmaceutical chemistry, biotechnology and agro chemistry. In combinatorial chemistry created large molecules can be detected efficiently.

Alstorm Syndrome , a recessively inherited autosomal rare genetic disorder usually caused by the mutations in ALSM 1 gene located on chromosome 2p13 characterised by the progressively developing multi organ pathology from the infancy stage but the exact function of ALSM 1 gene was still unknown. Alstorm Syndrome encompasses Cone Rod Retinal Dystrophy, Loss of Hearing, Truncal Obesity, Hypertriglyceridemia, Hyperinsulinemia, Insulin Resistance, Dilated Cardiomyopathy, Progressive Hepatic, Renal and Pulmonary Dysfunction Short Stature Infertility and normal intelligence but delayed psychomotor and intellectual development. Acquiring Clinical features, Age of Onset and severity of disease vary greatly among and even within family bearing identical mutations due to interactions of genetic modifiers. Progressive development of multiorgan damage leads to reduced lifespan not exceeding 50 years. Diagnosis is usually based on the clinical features observed but due to delay of onset of symptoms molecular genetic tests at any age confirms the diagnosis of disease. Due to gradual evolvement and variability of expression leads to delay in onset of symptoms which often leads to misdiagnosis. So far, there is no specific treatment that can cure, prevent or reverse the medical complications associated with Alstorm Syndrome. Early assessment of the disease, intensive medical management and multidisciplinary approach can detect and anticipate the complications that can be prevented and treated. Close monitoring, Prompt interventions and social support improve the overall outcomes generally and improve the life expectance and quality of life of all patients.

We Aim is to observe the prevalence of respiratory tract infections and sepsis in different age groups of children and evaluation of risk factors and their complications based on severity of disease. The objectives of this include such as identifying the Sociodemographic characteristics from infants to children. The data source is taken From case sheets of 125 patients admitted in GGH hospital in paediatric department, for the time period of 6 months by Observational study following the methods of severity assessment from patient demographics, including criteria of Age period 0-5 years, Infants, Toddlers, Children, Respiratory infections. Sepsis, Antenatal history of mother, Medication history of mother, Symptoms experienced by patients, Symptoms relieved by antibiotic treatment and excluded the Healthy patients. Age: Excluded >5 years children. Pregnant women’s, Neonates. Fisher exact test is performed to know the relation between respiratory problems and sepsis.

An attempt to study the Prospective, observation study was conducted In-patient department of Pulmonology, Siddhartha Multi Speciality Hospital Kakinada, and Andhra Pradesh India. In our study we aim incidence and prevalence of respiratory diseases based up on the study population. The Research study begins with standard questionnaire for collecting patient’s demographic details, diagnosis of the presenting disease condition. The case study was reported for a period of six months and the data obtained from the questionnaires was analyzed in Microsoft excel 2013. In this study strictly followed by inclusion and exclusion criteria, the study was conducted in for six months we conclude most of were interviewed in the study among whom the majority were Males who constituted a count of 57% (n=69) and females constituted 43% (n=51).According to the study, the age group distribution 31- 40 years constituting 27% (n=30) were more affected, followed by 71-80 years constituting 11% (n=15) followed by the rest of the age groups. For the environmental analysis conducted the majority of population affected were found in Rural 70% (n=84), where as urban is 30% (n=36). Daily Wages 38 % (n=45) followed by House Wife’s and students 23% and 17% respectively followed by others such as Employees, farmers. Illiterates mainly affected those who are Daily Wages when compare to the others. COPD is the most Common One 22% (n=28), Followed by Pulmonary KOCHS 13% (n=16) Viral pneumonia 12 %( n=14).

Verrucous carcinoma (VC) is a variant of squamous cell carcinoma often referred to as snuff dippers cancer because of its high rate of incidence in those who use snuff. A patient aged 57 years reported with a chief complaint of white growth in the left cheek region since 1 year. The growth was gradual in onset, and increased size since the patient noticed it. No history of pain, bleeding, or difficulty in swallowing was reported. No history of any topical application and no similar growths were noticed elsewhere in the body. The left cervical lymph nodes were involved to level 3 which were around 1 cm diameters soft and movable. Intraorally, a well-defined keratotic mass with finger-like projections on the surface was present of 5 cm × 4cm, roughly oval in shape, well-defined borders on buccal mucosa at the level of occlusal plane near the molar region extending anteriorly till the commisure of the lip. Based on the clinical appearance provisional diagnosis of VC was given after which incisional biopsy taken confirmed the lesion as verrucous hyperplasia (VH).Verrucous carcinoma is best treated with surgical excision of the lesion, which was already proven and has less chances of recurrence.

Background: Osteoarthritis is the most common chronic inflammatory musculoskeletal condition in older people. It’s a major cause of disability in elderly populations around the world, particularly in developed countries. Objective: The objective study was to assess the quality of life in Osteoarthritis patients by using adaptive SF-36 questionnaire form based on their physical and mental status. Methods: A prospective observational study conducted in both the outpatient and inpatient department of orthopaedics at the primary care hospital, Rajahmundry, Andhra Pradesh. An adaptive SF-36 questionnaire form was used which consists of 36 questions of 8 sub-scales in that, 4 sub-scales assess physical status and remaining 4 sub-scales assess the mental status of osteoarthritis patients to determine the quality of the life. Results: A total of 108 patients were screened for assessing QOL in OA. Among them, 55.6% of males are affected by OA more than 44.4% of females. A total of 39 (51-60 years of patients) 53.97% women’s detect worse health than men, based on their PCS and MCS. Conclusion: We assessed QOL in osteoarthritis patients based on their physical and mental status questions (sub-scales) in adoptive SF-36 Questionnaire form. Our study concludes that women’s health is in worse condition at the age of 51-60 than men.

The main objective is to investigate the irrationality of prescribing patterns of antibiotics in prescription. This helps in improvise rationality of antibiotics by enhancing quality of life and socio-economic status of patient. It is a prospective observational cohort study done at GBR Hospital, Narasaraopet, A.P. A total of 170 patients consisting of 101 males (59.4%) and 69 females (40.54%) were enrolled. Among these majority of patients 45 (26.47%) were in the age group of 41-50 years. 92 (54.12%) patients were prescribed with antibiotics in general medicine department. The most commonly prescribed antibiotics were Cephalosporin’s and tetracyclines. Majority of drugs 66.32% with single drug was prescribed in general medicine department followed by 23.68% in neurology. Of the 170 patients analyzed in various departments, it was observed that hospital physicians prescribed antibiotics more rationally with no banned drugs and lesser newer drugs. This study states that development of clinical pharmacy services is also necessary to improve rational prescribing of antibiotics. Utilizing of clinical pharmacy services shows benefit of patient health related outcomes and also improves the economic status of patients.

The present study was conducted to investigate the immune-pharmacological effects of atorvastatin on the cellular and humoral immune response of rabbits (either non-vaccinated or vaccinated with rabbit hemorrhagic viral disease vaccine). Two blood samples were collected from each rabbit (5rabbits /group) at the 1st and 3rd day, 1st, 2nd and 3rd week post vaccination and/or drug administration for studying both cellular and humoral immune response.

To evaluate in vitro anticancer activity on the MCF-7 cell line (Human breast cancer cell line) of Albizia saman (Leguminosae: family) flower extract. The monolayer cells were detached with trypsin-ethylene diamine tetra acetic acid (EDTA) to make single cell suspension and viable cells were counted using a hemocytometer. The cell suspension was diluted with medium containing 5% FBS (Fetal Blood Serum) to obtain final density of 1x105cells/ml. 100µl per well of cell suspension were seeded into 96-well plates at plating density of 10,000 cells/well and incubated to allow for cell attachment at 370C, 5% CO2, 95% air and 100% relative humidity. The results obtained from the in vitro studies performed using the human breast cancer cell line (MCF-7) reveals that the ethanolic extract of Albizia saman flower has a moderate anticancer activity with 94.72% growth inhibition at 200µg/ml. The IC50 value was 120.1µg/ml and the regression value was 0.999.

Introduction: Anemia was global health problem. It was highly prominent in India was caused by nutritional deficiency in younger individuals due to lack knowledge on diet. Methods and materials: This study performed in Sri Venkateswara college of Pharmacy, Etcherla, Srikakulam. And RIMS Hospital, Srikakulam. Study performed based on cohort study. Data was collected from student’s blood samples tested by using Sahlisehematometer manual method. Recorded data from hospital regarding pregnant women. Result: Total 300 samples was collected in that 100 student samples, 50 Pregnant women total 150 samples was effected with anemia in that younger female students was highly 16% anemic 9-9.9 Hb%, In males 28% lower anemic than females and also Hb% 12- 12.9 is higher than females. Discussion: In our study younger females were highly affected by anemia same as author study reported but they saying lack of knowledge on diet was leads to the Anemia. Authors in those study in Pregnant women 15-20 aged more women affected with anemia but in our study saying 21-25 years ages more women was affected by anemia. Conclusion: In our study highly females were affected with anemia due to lack of knowledge on diet, economical, social problem and more over now a day’s food habit life style.

: In total, of 173 prescriptions of the patient the total number of 329 drug interaction was found in which the 240 interaction was found in male and 89 in the female bearing the 72.90% and 27.10% respectively. Patient was of various age groups in which the maximum frequency was seen in the age group of 61- 70 years having 105 interaction bearing the percentage of 31.9% . According to the participation of different age group of the male and female with their corresponding age .The participation of male is high having frequency of 240 (72.9% )than female participation of frequency 89 (27.1%).The participation of male in the age group of 61-70 years is 83 and the female is 40 in the age group of 51-60 years. Potential drug interactions were categorized based on the gender. In that compared to 13 (40.6) females, males 19 (59.4%) were found to have more potential drug interactions. Our study more potential drug interactions in adult patients. Because, in adults lacking of nutrition’s and in elderly patients multiple prescribers, multiple drugs and multiple diseases. The number of potential DDI increased with an increase in the number of drug prescribed. The numbers of drug prescribed increase with age .This drug interaction have a potential to increase or decrease the therapeutic effect or to increase the risk of ADR. An increased awareness of PDDIs , rational co –prescription of drugs and a close monitoring of patients in whom these drugs are prescribed is recommended .The recommendation is based on the special monitoring and the perspiration of the clinical pharmacist .The Drug interaction observed in the geriatric patient are more severe and common in compared to the other group of study. The geriatric patient are physiological disability in correspond with the first pass metabolism and the presence of the other disease which also enables the multiple prescription causing poly pharmacy. The gender specification also the cause of the interaction , the female are more prone to the drug interaction due to the hormonal distribution in the body and inability of the physiological function to absorb and the distribution .The special training should be provided to the pharmacist for looking forward of the geriatric patient and female patient .The training regarding the prescription their adherence ,use ,toxicity , dosage regimen ,are being properly enabled in the training for the practical application . This study helps to know the different interaction related to the cardiovascular agent with own class of the drug and the other class of drugs used therapeutically to care the disease.

Background: Skin diseases have a serious impact on an individual’s health related quality of life. Occasionally skin diseases can be a manifestation of systemic diseases. Prescribing pattern studies are pre requisite for the formulation of drug policies. They offer useful methods for teaching and training in drug therapy and also identify the problems that arise from drug usage in healthcare delivery system and highlight the current approaches to the rational use of medicines. Aim: The aim of this prospective study is to assess the drug pattern of skin diseases in tertiary Care hospitals and their impact on patient’s health related quality of life. The objectives for this study were to perform an evaluate the prescribing pattern of skin diseases & assess the effect of skin conditions on patients quality of life. Methodology: A Prospective observational study was conducted in 190 adult patients presenting to the Department of Dermatology at various Tertiary Care Hospitals, Guntur, Andhra Pradesh, India for a period of 6 Months. Prescriptions of 190 patients attending dermatology outpatient department were collected and analysed. The variables assessed from the prescriptions includes the demographic profile of the patient, age, gender, socio - economic status, various common conditions related to skin, various classes of drug prescribed with their dosage form, dose, frequency and duration of administration. Results: In this study, a total of 190 populations were analysed among them majority of population accounting 53% of males and 47% of females. And the predominant age group of the presenting population was 21-30 years accounting 24%. The most common skin diseases are Tinea corporis (32.1%), Scabies (15.2%), Acne Vulgaris (8.9%), Urtricaria, and Eczema. Mostly patients were prescribed with anti-histamines, corticosteroids and antifungal medications. Conclusion: From this study, we conclude that male population of age between 21-30 years are more prone to skin diseases. Fungal infections formed the majority of presenting disease conditions and the effect on patient’s Quality of life was small to moderate and large effect on patient’s quality of life was considerably negligible. The most common disease among study population is Tinea corporis. The most common drugs & dosage form prescribed in our study were anti-histamines& corticosteroids used as a topical ointments.

Objective: The aim of the study is to evaluate the effect of the Hydroalcoholic extract of Moringa oleifera leaves on fertility hormone and semen quality of male albino rats. Materials and method: The Hydroalcoholic extract of Moringa oleiferaseed at doses of 100, 200 and 400 mg/kg were administrated for 30 days. The effect of the extract on body weight and sexual organs weights (testes and epididymis) were determined. The fertility hormone and semen characteristic was studied. Resultsand and discussion: Oral administration of Hydro alcoholic extract at doses of 100, 200 and 400 mg/kg were significantly increased body weight and sexual organ weight. Also significantly increased serum Testosterone, Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH) compared to the control group, in addition, significantly increased semen characteristic in experimental animals study. Conclusion :The results of the present study demonstrate the effectiveness of Moringa oleiferaseed extract on fertility hormones stimulator and improvement of semen characteristic which justify the traditional use of the plant as aphrodisiac and for management of male certain sexual disorders.

Nanotechnology is a developing interdisciplinary field of research interspersing material science, bionanoscience, and technology. Nanoparticles are studied extensively for their specific catalytic, magnetic, electronic, optical, antimicrobial, wound healing and anti-inflammatory properties. The main aim of the present study was to synthesize ZnO nanoparticles using the aqueous extract of Rhizophora mucronata leaves and to evaluate their antimicrobial efficacy against some selected microbes. The synthesis Zn nanoparticles were characterized by UV/VIS spectroscopy, particle size analyzer and Scanning Electron Microscopy. The synthesized Zn nanoparticles showed significant antimicrobial activity against Gram-positive and Gram-negative bacteria as well as against a fungal strain. .A clear zone inhibition was measured;40.05mm±0.137 for Staphylococcus aureus, and 36.15 mm ± 0.304 for Escherichia coli that comparably better result than a standard antibiotic. Thus from this study, it can be concluded that rhizophora mucronata extracts can be effectively used for synthesizing Zno nanoparticles. This study also suggests that green synthesized Zn nanoparticles can be used as an alternative to existing antimicrobial agents.

Background: Chemotherapy of cancer has many side effects. Nausea and Vomiting happen to be one of the most common side effects of chemotherapy in cancer patients. One of the most common symptoms seen in cancer patients is pain. It may limit the efficacy of work in daily life activities of the patient. Pain is defined as a highly unpleasant physical sensation caused by “illness or injury”. Nausea is the sensation of being about to vomit. Vomiting or emesis is the expelling of undigested food through the mouth. Aim: The aim of this study is to evaluate the pain management in cancer patients and telephonic assessment of nausea and vomiting. Methodology: This study was conducted with the objective to assess the pain, to evaluate the management of pain in cancer patients, to evaluate the incidence of nausea and vomiting through questionnaires via Telephone, in Care hospitals, Hi- Tech city, Hyderabad. This study is observational in nature and the subjects enrolled under this study were about 116. Informed consent was obtained from all the subjects. Subjects recruited in this study were admitted as in patients in the hospital to receive chemotherapy. The assessment of pain is done by using Visual analogue scale. Results: In this study, a total of 116 subjects with cancer were evaluated. Out of 116 subjects 109 subjects (93.9%) had mild pain and 07(6.03%) subjects were having moderate pain. For 69 subjects (59.4%) Tramadol was given, for 41 subjects (35.3%) Tab. Ultracet was given and for 06 subjects (5.17%) Morphine was given. 12 subjects (10.3%) had nausea, 5 subjects (4.31%) had vomiting, 3 subjects (2.5%) had both nausea and vomiting. Whereas 96 subjects (82.7%) had no incidence of nausea and vomiting. In most of the subjects there was no incidence of Nausea and Vomiting, as they were administered with Pre-medications during chemotherapy cycle and during discharge, 74 subjects (63.06) were prescribed with Tab. Zofer, 42 subjects (36.2%) were prescribed with Tab. Domstal. Conclusion: A total of 116 patients were observed who are undergoing chemotherapy. Among them mild pain is dominant with 109(93.9%) subjects, 59.4% of subjects were receiving Tramadol for pain management. Absence of nausea and vomiting is prominent with 96 subjects (82.75) as they were administered with pre medications during chemotherapy as prophylaxis for nausea and vomiting. Zofer is prominent as it is prescribed as discharge medication after chemotherapy with 72(62.75%) subjects. Out of which, 109(93.95) subjects are independent of others to perform their daily activities.

Alzheimer’s disease (AD) is the most common progressive neurodegenerative disease and the most common form of dementia. There are two major types of AD these are early onset Alzheimer’s disease (EOAD) and late onset Alzheimer’s disease (LOAD). The genetics of EOAD are largely understood with mutation in three different genes leading to the disease. Here we review the known genetics of EOAD. The most widely accepted hypothesis is the amyloid cascade hypothesis. Preliminary data suggest that CSF markers such as Aß and Tau levels may be considered as a helpful tool in the diagnosis of early onset Alzheimer’s disease (EOAD). Assessment of biomarkers in EOAD should be recommended in order to increase diagnostic accuracy in those cases with atypical presentation and /or familial aggregation of the disease. The typical presentation is more frequent in EOAD than in late onset Alzheimer’s disease (LOAD). To date more than 160 highly penetrant but rare mutation have been described in three genes amyloid precursor protein(APP), presenilin 1(PSEN1) and presenilin 2(PSEN2). PSEN1 is the most frequently mutated EOAD gene with a mutation frequently of 18-50% in autosomal dominant EOAD.

During the pregnancy time most of the pregnancy women suffering with various disorders. On that polycystic ovary syndrome (PC0S) plays a major role. If a pregnant women having polycystic ovary syndrome (PCOS) it shows various pathophysiological changes in pregnant women. According to world health organization PCOS is the commonest cause of an ovulatory infertility.

The first trimester is the most critical stage of development during which the rudiments of all the major organ systems appear. The second trimester is characterized by the nearly complete development of organ systems. The third trimester represents a period of rapid fetal growth. The risks related to pregnancy in those over 35 years, old, especially primiparity. The higher rates of fertility (age specific fertility rate) were seen in women from 25-29 years or from 30-34 years29. Women are still considered to be the sole responsible for pregnancy, while men continue being absolved or omitted from their participation in the reproductive even. One of the most common risk factors for a high risk pregnancy is the age of the mother. Women with age under 17 or over 35 are at greater risk of complications than those between their late teens and early 30s35. It is advantageous to diagnosis the pregnancy as promptly as possible when a sexually active woman misses a menstrual period or has symptoms suggestively of pregnancy. In the event of Desired Pregnancy, prenatal care can begin early and potentially harmful medications and activities such as drug and alcohol use, smoking and occupational chemical exposed can be halted.

Intracerebral haemorrhage is when blood suddenly bursts into brain tissue,causing damage to brain.Intracerebral haemorrhage is an important health problem leading to high rates of death and disability in adults. And it is the most devastating and disabling type of stroke. Uncontrolled hypertension is one of the most common causes for spontaneous intracerebral haemorrhage. Although the number of hospitals for admission for ICH has increased worldwide in past 10 years, mortality has not fallen. Significant treatment approaches include, early diagnosis and haemostasis, aggressive management of hypertension. Factors such as chronic hypertension; cerebral amyloid angiopathy and anticoagulation are commonly associated with intracerebral haemorrhage. Chronic arterial hypertension represents the major risk factor for bleeding. The incidence of hypertension related intracerebral haemorrhage is decreasing in some regions due to improvements of treatments in the chronic hypertension, anti-coagulant related ICH (vitamin-k antagonist and new oral coagulant drugs), represent an increase in the cause of ICH.

Neuroleptic malignant syndrome (NMS) is one of the serious complications of antipsychotics that occur rarely. Its prevalence is more commonly seen in individuals of age 20 to 40 years. Major etiology includes depletion of dopamine levels in central nervous system (CNS). It usually occurs, when high doses of antipsychotics are administered or sudden change in doses of antipsychotics or any withdrawal of anticholinergics abruptly. Sometimes, NMS follows withdrawal of dopaminergic medication in Parkinson’s patients. It is characterized by ‘lead pipe’ muscle rigidity, autonomic dysfunction, hyperthermia, extra pyramidal side effects. Clinical manifestations of NMS resemble malignant hyperthermia, serotonin syndrome, lethal catatonia and infectious disorders of CNS. NMS is a diagnosis of exclusion, thus differential diagnosis is of utmost important, by an expertise clinician. Laboratory findings that help in diagnosis are creatine phosphokinase (CPK) levels, leukocyte count, myoglobinuria and liver enzymes. Most lethal complication constitutes death, due to multi organ failure which accounts 10% to 20 % of renal and cardiovascular failure. Management comprises of prompt withdrawal of offending antipsychotic agent/neuroleptic drug after diagnosis, dopaminergic agonists are administered and supportive care is provided to the subject. A prompt medical attention is required as a consequence of high mortality. Thus, the treatment options were proposed to reduce the mortality due to NMS in clinical settings. Key words: Antipsychotics,Dopamine agonists, Malignant hyperthermia, Neuroleptic malignant syndrome, Neuroleptics.