Prescription auditing: an important tool for sensitization of resident doctors for rationale prescription and utilization of drug

Background: The main objective of the Maharashtra Health Systems Development Project (MHSDP) is to enhance the quality of care by improving health care; in the hospitals, in the state. Improvement in the prescribing practice of resident doctors working in the hospitals is one of the initiatives taken up, to improve the rationalizing service delivery. A prescription audit may become an important tool for sensitizing resident doctors for rational prescription and utilization of drug.Methods: An observational study was carried out during the period of March 2017 to May 2017 in tertiary care teaching hospital, Kolhapur. Total 247 first prescriptions written by resident for in-door-patient department were collected, scrutinized and analysed. Prescriptions were evaluated for completeness of prescription format while legibility was graded. Prescriptions were also analysed as per World Health Organization prescribing indicators.Results: In study 247 prescriptions with 1091 drugs with average 4.42% drugs per prescription, 49.8 % prescriptions wrote the drugs by generic name. We found that 44.1 % prescriptions written with drugs included in essential medicines list while antibiotics prescribed were 27.1%. In prescription format 34% had incorrect dosage, 67% of prescriptions omitted the duration of treatment. Direction for drug use was not mentioned in 25% of prescriptions. Weight was not mentioned on any prescriptions even for paediatric group.Conclusions: Through prescription auditing, sensitizing resident doctors for rational prescription and utilization of drug can be done to achieve the goal of the MHSDP of enhancing the quality of care by improving health care; in the hospitals, in the state.

Cost comparisons of seven leading brands of the Hypolipidemic drug, Rosuvastatin available in an India city

Background: Hypolipidemic drugs need to be prescribed lifelong for most of the selected patients, once started. Price variation can lead to huge financial strain on the patients, especially when cost associated issues are not considered by the prescribing medical practitioner. This study was conducted to compare the cost, to the patient, of seven most commonly prescribed preparations of different brands of Rosuvastatin ten milligram, in Kolhapur city.Methods: Authors purchased a strip of 10 capsules each of the seven leading brands of Rosuvastatin ten milligrams. The prices of the strip of 10 capsules of each of the seven chosen brands were compared. Finally, the cost of each of these seven brands for one year, was compared directly as well as using percentages. The data was collected, analysed and presented in tabular forms and figures.Results: The data of the cost of seven different brands of a single hypolipidemic drug, Rosuvastatin ten milligram shows that the cost of the costliest among the seven brands of this drug for one year is almost two times that of the cheapest brand, or in other words almost 200 percent that of the cheapest brand.Conclusions: The cost differences between the cheapest and the costliest brands were substantial. The cost of remaining five brands was dispersed in between these two extremes. India, with a major part of the population being highly concerned about the cost of medications, the prescribing medical practitioner must select the preparation wisely . The most costly preparation of Rosuvastatin ten milligram can substantially add to the financial strain on the patient’s yearly expenses. Thus, Pharmaco economic considerations must be a prime concern while making a decision to prescribe medicines, especially in a country like India.

Knowledge, awareness and attitude regarding WHO recommended ANC visits among pregnant women attending antenatal clinic at D.Y. Patil hospital, Kolhapur, Maharashtra, India

Background: ANC is the care woman receives throughout the pregnancy in order to ensure that both the mother and child remain healthy. Promotion of maternal and child health is the most important component of family welfare programme of Govt. of India. It is useful to promote, prevent and protect maternal and perinatal health for the sustainable growth and development of country. Unfortunately, many women in developing countries do not receive such care. This study is conducted to identify, address and to assess the awareness and knowledge about own health during pregnancy and to improve maternal health, to improve maternal health services and to limit barriers among health systems working at all levels.Methods: This study is done in D.Y. Patil Hospital, Kolhapur among pregnant women attending ANC from April to June 2017. A questionnaire was used to collect data and assessed in either positive or negative response. Statistical analysis was done in terms of percentage.Results: During the analysis 48.1% had knowledge about ANC check-ups and 26.7% admitted about the importance of ANC check-up and visits. Regarding awareness, 35.8% were aware about the importance of ANC card, 28.3% were aware about the parameters, check-ups and investigations. 23% agreed that each ANC visit can improve the health and baby抯 growth, while evaluating Attitude 32.6% enquired about their improvement or complications they will have to face.Conclusions: Present study data is baseline but informative for further planning of health in intervention programme. It is also useful for enhancing awareness of antenatal care and for motivating the women to utilize maternal care services.

In vitro propagation of a rare medicinal fern of Western Ghats – Diplazium esculentum (Reytz.).

Present study aimed for in vitro culture of circinate part of young leaves of D. esculentum which is amongst the leafy vegetables consumed as vegetable by Paniya and Chetti tribes of Western Ghats. The circinate part of young leaves (crosiers), excised before the beginning of foliar expansion, was inoculated on half strength Murashige and Skoog (MS) medium supplemented with auxins indole-3-butyric acid (IBA) or α-napthalene acetic acid (NAA) or 2,4-Dichlorophenoxyacetic acid (2,4-D) and cytokinin 6- benzylaminopurine (BA) in a range 0.5 to 2.5 mg L-1. Combinations of different concentrations of 2,4 D + BA, IBA + BA as well as of NAA+ BA were also tested in half strength MS medium with 3% sucrose and with pH 5.8. The best morphogenic response was obtained with half strength MS medium supplemented with 2,4-D 0.5 mg L-1 and BA 2.5 mg L-1, 3% sucrose, at pH 5.8. For rooting of the microshoots, half strength MS medium supplemented with 2,4-D ( 2 and 1 mg L-1 ) exhibited best results. Present study reports the successful in vitro culturing of D. esculentum.

Characterization of carbamoyl phosphate synthetase of Streptomyces spp.

Carbamoyl phosphate synthetase (CPS) activity in Streptomyces lividans was repressed (70%) by addition of arginine and uracil in the growth medium. Enzyme activity was also inhibited by UMP and activated by ornithine and IMP. Pattern of inhibition and activation was similar irrespective of whether the cells were grown in medium supplemented with arginine or with uracil. A mutant of S. coelicolor with dual auxotrophy for arginine and uracil possessed only about 20% of CPS activity compared to the wild-type strain. An activity staining protocol has been developed for CPS enzyme. Using this method a single CPS band has been observed in the crude extracts of Escherichia coli as well as in S. lividans. Taken together, our results supported the conclusion that Streptomyces species might possess a single CPS enzyme unlike other gram-positive bacteria, which show the presence of two pathway-specific isozymes (Bacillus) or none (Lactobacillus and Leuconostoc).