Kolli Narotham Reddy

The controlled processes that provide functional integration between cells and organs are impaired in the elderly persons. As a result, there occur failures to maintain homeostasis under physiological stress conditions. In the advancing age, the important pharmacokinetic as well as pharmacodynamics properties are tremendously changed. In elderly patients failure to maintain the pharmacokinetic changes include decreased absorption of number of drugs, increase in volume of distribution of drugs, decrease hepatic and renal clearances where as pharmacodynamic changes involve usually altered sensivity to number of classes of drugs such as cardiovascular, anticoagulants and psychotropic drugs. The inappropriate medication use is a major health care issue for the elderly population. Beers criteria were developed in 1991 to define inappropriate medication use of elderly. By developing these new criteria, a clear picture emerged for a list of medications with questionable benefit and/or significant risk that should be avoided in older adults.

Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by fibrosis and vasculopathy. It is a rapidly progressing disease and wide spreading dysfunctioning of various organs includes kidney, gastro intestinal, cardiovascular systems and etc. Annual incidence is 19 per million, and prevalence is 19-75 per 100,000, with a female: male ratio of 3:1, and 8:1 in mid to late childbearing years. Incidence is twice as high among African Americans. The data was collected from in-patient record book in the Deportment of Dermatology in a tertiary care hospital in India for a period of March 2011 to February 2013. A total of 180 patients were recorded in the in-patient record book of the Department of Dermatology in a tertiary care hospital for a period of March 2011to February 2013. Among the patients of systemic Sclerosis the dominating age groups were 21 to 30 years and 31to40 years. In the study most of the females 144 (80%) patients out of 180, males 36 (20%) patients out of 180 are having Systemic sclerosis disease. The female/male ratio of disease is 4:1.