ABSTRACT
Background: Migraine is a debilitating neurological disorder. As a leading cause of disability worldwide, it affects health-related quality of life (HRQoL). There are limited studies assessing the prescription pattern and improvement in HRQoL post-treatment. Aims and Objectives: This study aims to evaluate the drug use pattern and compare the effects of medications on HRQoL as per Migraine Disability Assessment Score (MIDAS). Materials and Methods: A prospective observational cross-sectional study was conducted on migraine patients attending neurology OPD at a tertiary care hospital. One hundred and seven patients were recruited by periodic sampling over 6 months. Prescription indicators assessed were number of antimigraine drugs per prescription, frequency of prescribed drugs, prescriptions by generic name, etc. Data were analyzed using descriptive statistics. The HRQoL was assessed after 3 months of medications by telephonic questionnaire. The change was analyzed by Wilcoxon matched pair signed-rank test. Results: Majority patients were in the third (40.2%) and fourth decade (32.7%) with a female preponderance (72.9%). Nonsteroidal anti-inflammatory drugs were commonly prescribed for aborting acute attacks with naproxen (24.1%) followed by diclofenac (2.71%). Prophylactically topiramate (27.51%), amitriptyline (18.6%), and propranolol (3.1%) were prescribed. About 36.43% of drugs were prescribed by generic names. Improvement in HRQoL was reflected by a significantly reduced MIDAS (13.95 ± 5.20 to 11.39 ± 5.07 [P < 0.05]). Conclusion: In our study, there was low generic prescribing. Naproxen was most prescribed for acute migraine and topiramate for prophylaxis. The HRQoL significantly improved after 3 months of antimigraine medications causing lesser disease burden.
ABSTRACT
Objective: To evaluate anti-inflammatory effects of ramipril in experimentally induced rheumatoid arthritis (RA).Materials and Methods: Adjuvant induced arthritis model is used in this study.Albino-Wistar rats of either sex were used. Arthritis was induced by single intradermal injection of Freund’s complete adjuvant (FCA) suspended in oil inplantar region of right hind paw. Rats were divided in to three groups (n=8) namely disease control, standard and test group. Drug treatment was carried out for 21 days. Effect of test drug on acute inflammatory phase was evaluated on day 5 by assessing right hind paw edema. After 21 days animals were sacrificed and evaluated for left hind paw edema, weight changes, histo-pathological synovitis grading in left hind limbs and secondary lesion score.Results: Results showed that ramiprilsignificantly reduced right hind paw edema on day 5 (p<0.05). Ramipril also showed statistically significant weight gain (p<0.05), reduction of histo-pathological synovitis grade (p<0.05) as well as secondary lesion score (p<0.05).Conclusion:Our study suggests that ramiprilmay be used as an adjuvant anti-inflammatory agent in patients with RA. However this speculation needs to be confirmed clinically.