ABSTRACT
Background: Antimicrobials are most commonly prescribed drugs worldwide. Around 50% of the prescriptions of antimicrobial drugs are either not needed, inappropriate or in wrong doses. With the widespread use of antimicrobial agents (AMAs), the prevalence of resistance has increased. To evaluate the prescription pattern and utilization of AMA in ear, nose, throat (ENT) outpatient department (OPD) of Tertiary Care Hospital, Nanded. Methods: This prospective study was conducted in ENT OPD of Dr. Shankarrao Chavan Government Medical College, Nanded over a period of 3 months. During this period, approximately 1100 patients visited ENT OPD and 600 prescriptions were evaluated. The excluded patients were of post-operative follow-up and of patients undergoing medical examination for fitness and handicap certificate. Data were collected by using specially designed case report form. Appropriateness of AMA was assessed by Kunin’s modified criteria. Results: Total 600 prescriptions were analyzed out of which (91%) consist of AMA. Most of them reported with upper respiratory tract infections (URTI) (30.4%), chronic suppurative otitis media (21.4%), acute suppurative otitis media (10.4%), tonsillitis (3.3%), sinusitis (2.7%), and others (15%). Amoxicillin (43.9%) was preferred AMA followed by ciprofloxacin (30.6%), cotrimoxazole (5.8%), azithromycin (3.2%), doxycycline (3.2%) cefixime + clavulanate (3.2%), and amoxicillin + clavulanate (1.8%). Single antibiotic was preferred in all prescriptions. In the concomitant medications, antihistaminics were prescribed in 97.22% of patients, non-steroidal anti-inflammatory drugs in 94.96% of patients, and antacids in 87.76% of patients. Fixed-dose combinations were used in 10% of prescriptions. Brand names of AMA were used in 10% of prescriptions. As per the Kunin’s modified criteria, 83% of patients received AMA therapy appropriately, while 17% patients inappropriately. Conclusions: Amoxicillin is the most common AMA prescribed and URTI is the most common diagnosis made. All AMAs should be prescribed only when needed and should be used in proper dose and for proper duration. Institution wise antibiotic policy should be used to contain resistance. Proper training and regular orientation programs of the juniors’ doctors for judicial use of AMAs will foster the habit of rational prescribing of AMA.
ABSTRACT
Background: Acetaminophen (paracetamol) toxicity is a common cause of drug induced hepatotoxicity in children and adults. Specific treatment of paracetamol induced hepatitis is available in the form of N acetylcysteine only. Nigella sativa (NS) is used for the treatment of various ailments. Many studies have shown that NS plant has hepatoprotective potential. Hence, this study study was carried out to explore the prophylactic and therapeutic effect of NS oil against hepatotoxicity induced by paracetamol. Methods: Hepatotoxicity was induced in rats by paracetamol and it was assessed using biochemical parameters such as serum (Sr.) alanine aminotransferase (ALT), Sr. aspartate aminotransferase (AST), Sr. bilurubin, Sr. alkaline phosphatase, and Sr. total protein. In addition, histopathological score was also assessed. The therapeutic and prophylactic effect of NS oil administration on paracetamol induced hepatotoxicity was investigated by using above mentioned biochemical and histopathological parameters. Results: Paracetamol administration leads to rise in serum liver enzymes ad fall in Sr. total protein levels. NS oil has heptoprotective effect. NS oil significantly reversed changes in serum levels of AST, ALT, alkaline phophatase, bilurubin, and total protein produced by paracetamol. Furthermore, histopathological changes produced by paracetamol were reversed. Conclusion: This study demonstrated that NS oil has hepatoprotective effect. NS oil administration can prevent or reverse the hepatotoxicity induced by paracetamol.
ABSTRACT
Fixed drug eruptions are common cutaneous adverse drug reactions, commonly caused by anticonvulsants, antibiotics and analgesics. Here, we report a case of a 27-year-old male of fixed drug eruptions due to Aspirin which was used in treatment of headache.
ABSTRACT
Background: Drug-induced hepatotoxicity is a potentially serious adverse effect of antituberculosis treatment (ATT) regimens containing isoniazid, rifampicin and pyrazinamide. Many in vitro and in vivo studies revealed that honey possess antioxidant property and hepotoprotective property but there is no systematic work available to test the effect of honey on antitubercular drugs induced hepatotoxicity in rats. Hence present study was carried out to explore the prophylactic and therapeutic effect of honey with its antioxidant activity against hepatotoxicity induced by antitubercular drugs (Isoniazid, Rifampicin and Pyrazinamide) in albino rats. Methods: Hepatotoxicity in rats treated with antitubercular drugs (Isoniazid, Rifampicin and Pyrazinamide) was studied by assessing parameters such as Serum alanine aminotransferase (ALT), Serum aspartate aminotransferase (AST), Serum total protein, Serum Malondialdehyde (MDA) and Serum Superoxide dismutase activity (SOD). The effect of Honey as co-administration and administration after establishment of hepatotoxicity on above parameter was investigated. These biochemical observations were supplemented by Histopathological examination of liver. Results: Honey significantly reversed changes in serum levels of AST, ALT, MDA, SOD, total protein and also histopathological changes produced by Antitubercular drugs. It was found that honey significantly prevented as well as reversed Antitubercular drugs induced hepatotoxicity and antioxidant activity. Conclusions: The results of present study show that honey has significant prophylactic and therapeutic value against antitubercular drugs induced hepatotoxicity.