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INTRODUCTION - Drug utilization studies assess appropriateness of pharmacotherapy. Rheumatoid arthritis (RA) is an autoimmune disease, which, if untreated, may result in degradation of joints. OBJECTIVE - To evaluate the prescribed drugs according to WHO drug use indicators. METHODS - Data collected included Demographics, details of medications prescribed for RAand other co-morbidities. RESULTS – Average no of drugs per prescription were 4.98 ± 1.21. Methotrexate was prescribed to every patient. Percentage of patients prescribed Single DMARD, Two DMARDS and Three DMARDS were 10%, 48% and 42% respectively. 99.38% and 90.68% of the Drugs for RA were prescribed from NLEM 2015 and 20th WHO Model List of Essential Medicines (March 2017) respectively.75.9% drugs were prescribed by Generic name. CONCLUSION –The standard treatment guidelines for treatment of RAare followed. Drugs were mostly prescribed from the Essential drug lists. Majority of the drugs have been prescribed by generic names.
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Background: Epilepsy is the most common neurological condition with 65 million cases of active epilepsy found worldwide. The incidence is approximately 0.3 - 0.5% in different world populations with a prevalence rate of five to ten per thousand people. The aim of the present study was to evaluate the prescriptions according to WHO/INRUD drug use indicators and to study the adverse effects to antiepileptic drugs (AEDs).Methods: A cross sectional survey based observational study of 1year duration was conducted at tertiary healthcare hospital. Prescription data of patients (n=361) with Epilepsy from Neurology department was analysed using WHO indicators. The demographic data, type of seizures, AEDs prescribed and adverse drug reactions (ADRs) reported by the patients were recorded. Statistical analysis was done using Microsoft excel 2013.Results: A total of 593 AEDs were prescribed to 361 patients. Average number of AEDs prescribed per prescription was 1.65±0.78 (S.D) with only 02% of newer AEDs. Generalized Tonic Clonic (GTC) was the most common seizure with 55.68%. Phenytoin (32%) was commonly prescribed followed by valproate for GTCS. Carbamazepine was commonly prescribed for partial seizures. Out of 15 ADR cases that has been recorded, phenytoin (73%) was associated with most ADRs followed by valproate (20%). 53% patients were on Monotherapy, 31% on dual drug therapy.Conclusions: Older AEDs are still commonly prescribed drugs. Prescription of newer AEDs to be encouraged, as study revealed majority of adverse effects to drugs like phenytoin and valproate. Study concludes the need of creating awareness of reporting of adverse event to AEDs, in treating physician.
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Background: Antimicrobial resistance(AMR) is an urgent and serious global health problem, demanding considerable attention from health care providers(HCPs) all over the world. The threat is progressing rapidly and intensifying with time. Therefore study was conducted to assess the knowledge, attitude and practices of Homeopathic HCPs about antibiotic usage and resistance(ABR).Methods: Cross-sectional, observational study. The data was collected from 75 Homeopathic HCPs practicing in Maharashtra with prior informed consent. Questionnaire based study whose responses were assessed by using five point Likert scale and analysed by using appropriate descriptive statistics.Results: 68(90.67%) respondents agreed that antibiotics are overused in India and 70(93.33%) of them facing ABR in their daily practices. Only 62(82.7%) of them were aware of the fact that bacteria are not responsible for causing colds and flu. 33(44%) believe that skipping one or two doses of antibiotic does not contribute to ABR. Only 23(30.67%) knew drug schedule H correctly. 22(29.33%) opined that antibiotics should be discontinued if patient develops mild gastrointestinal side effects. Only 28(37.33%) reads patient information leaflet(PIL) and counsel patients accordingly. 28(38.67%) feel that they don’t have enough sources of antibiotic information and 35(46.67%) find it difficult to select appropriate antibiotic.Conclusions: Most of HCPs were aware of rising issue antibiotic resistance. However, their knowledge, attitude and practices were found to be a matter of some concern. Educational intervention can be introduced to bring about behaviour changes regarding rational antibiotics prescribing. Government should take initiative against overt antibiotic promotional advertisements and to curb over the counter(OTC) sell of antibiotics.
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Stevens Johnson Syndrome is a rare but life-threatening skin disease and Carbamazepine is considered as one of the most common cause. The reported frequency of serious Carbamazepine hypersensitivity reaction is between 1/1000 and 1/10000 new exposures to the drug. Here, we report a case of a 40 year old female patient, who developed multiple ulcerative lesions all over the body three days after starting treatment with Carbamazepine for Trigeminal Neuralgia. (Worldwide Unique Number- 2017-58502 and AMC Report Number- BJGMC-Pune/Nov-2017/BBG-1860) Stevens Johnson Syndrome was diagnosed. Carbamazepine was withdrawn, and the patient was treated with topical and intravenous antibiotics. A biopsy was done which confirmed the diagnosis of Stevens Johnson Syndrome.
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Background: Pain and inflammation are the basic processes involved in the pathogenesis of many diseases. Non-steroidal anti-inflammatory drugs are often used to treat rheumatic diseases. The study compound N-Benzoyl Isoserine Methyl Ester (N-bime) is a newly synthesized propionic acid derivative by National Chemical Laboratory, Pune. Since the biological data of this compound is not available, the present study has been planned to screen this compound for anti-inflammatory, analgesic activity and its toxicity profile in animals.Methods: Single dose toxicity study was carried out in rats. Anti-inflammatory activity was tested by Rat Hind Paw Oedema and Cotton Pellet Implantation method. For Analgesic activity, Acetic acid induced writhing and Tail Pinch method was used. Yeast induced Pyrexia was used for evaluation of anti-pyretic activity. Ibuprofen was the positive control. Data are presented as mean±SEM. Statistical analysis was performed by analysis of variance and students unpaired‘t’ test.Results: The test compound N-bime did not show any apparent adverse effects or mortality in the dose range 1mg - 500mg / 100gm body weight in animals. It showed better anti-inflammatory actions in higher doses as compared to Ibuprofen (p? 0.05). In acetic acid induced writhing test N-bime offered better protection against writhes, than Ibuprofen. But, both failed to demonstrate analgesic activity in the Tail Pinch method. N-bime showed a gradual decrease in temperature in the anti-pyretic test (P<0.001).Conclusions: The present study indicates that N-bime does possess anti-inflammatory, analgesic and weak anti-pyretic properties like the NSAIDs. It has proved to be safe in the dose range of 1mg - 500mg / 100gm body weight in rats and mice.
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Background: Cardiovascular disease is very prevalent in India. So, use of cardiovascular drugs is also more. So, it is very important to keep watch on adverse drug reactions. Aim of this study was to assess the pattern of adverse drug reactions (ADRs) reported with cardiovascular drugs in a tertiary care institute.Methods: The study was carried out in medicine department of a tertiary care hospital over a period of one year. Each ADR was analysed for demographic data, causality, relationship between frequency of ADRs and the number of drugs used etc. In statistical analysis Microsoft excel 2013, SPSS software was used.Results: A total of 136 patients, 58 (43%) men and 78 (57%) women, using cardiovascular medications reported ADRs during the entire study period. Total 168 ADRs were reported out of which, Amlodipine (causing headache and edema feet) was the most common drug with 51 (30.3%) ADR’s followed by Enalapril, Aspirin and Isosorbide Dinitrate with 37 (22%), 24 (14.2%), 23 (13.6%) ADRs respectively. Most common ADR was headache (due to amlodipine and Isosorbide di nitrate) affecting 38 (22.62%) cases followed by dry cough 37 (22.02%) cases, edema feet 36 (21.43%), gastritis 24 (14.29%) and 10 (5.95%) of nausea.Conclusions: Monitoring ADRs in patients using cardiovascular drugs is a matter of importance since this class of medicines are mostly used as multidrug therapy and always prone for ADRs.