A questionnaire based study to assess the interns’ knowledge about the brand names of drugs routinely prescribed in a tertiary care hospital in Kerala, India

Background: The gap in the knowledge of interns between brand names, generic name and indication of a drug can lead to unwanted clinical consequences. This study was conducted to assess the knowledge of interns at a tertiary care hospital regarding the generic name and indications of the routinely prescribed brand names of drugs.Methods: In this study, interns were required to write whether they prescribed the brand names mentioned in the questionnaire in the preceding six months, their generic name and the indication for their use. Results were expressed using descriptive statistics.Results: All brands except Zovobact SB was prescribed by more than 50% of interns in the preceding six months. The generic equivalents were correctly identified by good percentage of interns for Hicet (100%), Asthalin (95%), Cifran (90%) but the percentage of correct answers was low for other brands. For combination brands, correct generic names of all components were identified by more than 50% of interns for oflox TZ (93%), Septid D (68%) and Losar H (68%). The percentage of correct response for the indication of the brands was satisfactory for Hicet (100%), Asthalin (98%), Cifran (98%), Zerodol P (100%), Cyclopam (100%), oflox TZ (100%), Losar H (98%), Septid D (98%) but was inadequate for Taxim O (48%), Betaloc (33%), Valium (23%), Diamox (0%), Quadriderm (31%) and Zovobact SB (31%).Conclusions: This study identified lacunas in the knowledge of interns regarding generic equivalents and indications of brand names. Strategies to overcome the problem should be devised to ensure patient safety.

Drug utilization pattern in orthopaedic outpatient department of a tertiary care hospital in Kerala: a geriatric perspective

Background: Geriatric population due to the age related changes in pharmacokinetics and pharmacodynamics and the presence of comorbidities is vulnerable to drug interactions, adverse effects and high cost of therapy. This necessitates a periodic review of DU pattern in the geriatric population to ensure safe and effective treatment for them. The present study was undertaken to evaluate the DU pattern for medical conditions among the geriatric population in the Orthopaedic outpatient department (OPD) of a tertiary care hospital in Kerala.Methods: In this cross sectional observational study conducted in the Orthopaedics OPD of a tertiary care hospital, prescriptions were collected from patients attending the Orthopaedics OPD randomly over a period of 6 months. Out of these, prescriptions of male and female patients of age more than 60 years were sorted and analysed using World Health Organization drug prescribing indicators as well as additional parameters and the data was presented in the form of frequency and percentages using tables and charts.Results: A total of 800 prescriptions were collected and studied of which 76 (9.5%) belonged to patients from the geriatric population. Majority of the patients were in the age group of 61-70years (52.63%). Spondylosis (42.10%) was the most common indication for patients attending Orthopaedics OPD. Average number of drugs per prescription was 3.05 with a range between 1 and 5. Only 5.17% drugs were prescribed using generic name. Utilization from the essential drug list was 39.65%. The percentage of encounters in which an antibiotic and injection prescribed was 0% and 10.34% respectively. Of the total drugs prescribed 35% were FDCs. The most routinely prescribed drugs among the various classes were NSAIDs 34% followed by gastroprotectives (25%). The assessment of prescriptions with regard to completion and legibility was satisfactory.Conclusions: Current study pointed out deficiencies like polypharmacy, low prescribing of drugs by generic names, low prescribing of drugs from the essential drug list and higher use of FDCs. Use of antibiotics and injections was satisfactory and acceptable. Legibility and completion of prescription format was largely satisfactory. Proper strategies to rectify these deficiencies can ensure safe and effective treatment for geriatric patients.

Formoterol versus montelukast as add on therapy to low dose budesonide in persistent asthma: effect on lung function

Background: Choice between LABAs and LTRAs as add on drugs to low dose ICS in persistent asthma remains unclear due to limited data on the comparative efficacy of these two groups of drugs. The aim of this study was to compare the effects of formoterol and montelukast on lung function, when added to low dose Budesonide in persistent asthma.Methods: This was an institution based randomized open label study. 72 asthmatics satisfying selection criteria of the study were randomized to receive either inhaled budesonide and formoterol (FB group) or inhaled budesonide and oral montelukast (MB group) for 12 weeks. PEF value at end point was primary efficacy measure. Secondary efficacy measures were PEF values measured at the end of 1, 4 and 8 weeks and the end point value of FEV1.Results: Both the groups showed significant improvement in the lung function tests. However inter-group comparison showed that PEF value at end point of FB group was significantly greater than that of MB group (81.94%vs 63.82%, p<0.05). Notable observation was that the superiority of the FB group with respect to PEF values was maintained from the first week itself. FB group also had significantly better results than MB group for FEV1 (67.88% vs 64.88%, p<0.05).Conclusions: In the present study, formoterol was found to be superior to montelukast in improving lung function when added to low dose budesonide in persistent asthma.

Knowledge, attitude and practice of haemovigilance amongst healthcare professionals in Nashik, Maharashtra, India

Background: Haemovigilance Programme of India was launched in 2012 with the purpose to identify, analyse and learn the complications related to transfusion and blood donation, in order to avoid such complications in future. Though it is essential to identify the Adverse Transfusion Reactions (ATR) to reduce the incidence and make transfusion easier; there are rare reports available about knowledge, attitude, and practice (KAP) of Healthcare Professionals (HCP) for haemovigilance.Methods: In this cross-sectional study, pre-validated questionnaire designed for assessing the KAP, the possible ways to improve transfusion reaction reporting and causes of underreporting were distributed among 220 Healthcare Professional (HCP) in Nashik, Maharashtra.Results: The response rate of the study was 93%. Amongst them 58% HCP had poor knowledge while only 9% had good knowledge about haemovigilance. According to respondents, training to the HCP, CME’s, making reporting compulsory and launching of a toll-free helpline number will mark a milestone in improving transfusion reaction reporting. Legal liability issue and lack of time & knowledge were the main factors which discouraged them from reporting.Conclusions: Overall, most of HCP in Nashik have a positive attitude towards transfusion reaction reporting but knowledge regarding the haemovigilance concept is poor and the majority of them never reported ATR. Hence, our study demands increased awareness and continued training to strengthen the haemovigilance system, especially ATR reporting.

Drug Prescribing Pattern in Ophthalmology Out Patient Department of a Medical College

Background: The pursuit of best and responsible use of medicines is the basis for concept and effort of Rational use of drug. RUD addresses steps in supply-use chain of drugs i.e. selection, prescribing, dispensing, monitoring and feedback. Hence periodic and continuous auditing of drug prescribing pattern is vital tool for promotion of RUD. Ophthalmology largely becoming an outpatient and day care department with almost nil Inpatient. So present study is to analyse drug prescribing pattern in Ophthalmology OPD. Methods: A prospective cross sectional study was done. Prescription were analysed for number of drugs per prescription, number of antibiotics, no of injection per prescription, Drugs from Essential Medicine List, Fixed dose Combinations. Results: A total of 176 prescriptions were analyzed the average number of drugs per prescription being 2.7 [0.78].Eye drops being the most common (81.01%) dosage form. injections were only 0.63% of all drugs. Percentage of prescription with Antibiotics were (36%) All drugs were prescribed only in brand name, none by generic name. 40.29% (940/1516) of drugs were prescribed from essential medicine list. Almost all prescriptions were having clear information on dosage form, dose, frequency and duration of treatment. Conclusion: Out of different parameters and drug prescribing indicators some are satisfactory e.g Information for patient in prescription. Some others like absence of generic name in prescription, high %age of antibiotics, lower % of drugs from EML needs attention. Conclusions: . It seems that awareness among the clinician about Rational prescribing is increasing. There is need of continuous endeavour to sensitise the clinician for rational use of drug.

Reversible isolated thrombocytopenia: a rare adverse effect of diclofenac infusion.

Diclofenac infusion is prescribed for acute painful and inflammatory conditions in intensive care. Thrombocytopenia is a very rare adverse effect of diclofenac infusion. We report a case of thrombocytopenia due to diclofenac infusion, occurring in a 32-year-old male treated conservatively for acute appendicitis. The thrombocytopenia recovered completely with the discontinuation of the drug. The rarity, clinical importance, and the diagnostic difficulty associated with this case prompted us to report it here.

Study of Phytochemical and Antimicrobial Potential of The Leaves of Nilgirianthus Ciliatus Linn.

The present study was carried out to identify the phytochemical constituents and to evaluate antibacterial and antifungal activity of Nilgirianthus ciliatus Linn using ethanol, chloroform, petroleum ether and aqueous extracts on selected four bacterial pathogens such as Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa and two fungal strains Aspergillus niger and Candida albicans (Fungus-unicellular/ multicellular yeast). For the antimicrobial test, cup plate method was used and the zone of inhibition was measured in mm. The extracts showed significant antimicrobial activity and were compared with Amoxicillin and Ketoconazole. The chloroform extract showed the higher antibacterial activity with a zone of inhibition of 23mm against gram negative pathogens and minimum 15mm against Aspergillus niger from 150mcg/ml. Ethanolic and petroleum ether extracts showed similar activity with an inhibition zone of 12 and 11 mm against fungal strains Candida albicans and Aspergillus niger respectively from 150mcg/ml. The phytochemical analysis revealed the presence of alkaloids, carbohydrates, flavonoids, saponins; proteins and tannins. The powdered leaves were analyzed for various physicochemical constants also.

Mesiodens In India Children : A Report of Two Case And Review.

Paediatric dentistry in the current scenario is not only about teeth and gums that are visible in child's mouth, but also those structures that are hidden, difficult to identify, and often remain undiagnosed. Dentists can come across various anomalies pertaining to the crown structure during clinical practice. Supernumerary tooth is one such anomaly that is additional to the normal series and can be found in almost any region of the dental arch. They may be single, multiple, unilateral or bilateral erupted or un-erupted and in one or both jaws. Mesiodens is the most common type of supernumerary tooth found in the premaxilla between two central incisors. Here is a review of literature relating to mesiodens presented along with two case reports to illustrate some possible presentations, diagnostic features, and treatment options.