ABSTRACT
Aim: Irrational use of medicines is a global problem. In India, one contributing factor is the availability of a large number of fixed-dose combinations (FDCs). To improve rational use and to strengthen policies, it is important to assess the usage patterns and rationality of FDCs. Methods: This study was conducted as part of a 1-year prospective cross-sectional analysis of prescriptions in the outpatient clinics of broad specialities from 13 tertiary care hospitals across India. Five most commonly prescribed FDCs in each center were analyzed. In addition, all the prescribed FDCs were classified as per the Kokate Committee classification and it was noted whether any of the FDCs were irrational or banned as per the reference lists released by regulatory authorities. Results: A total of 4,838 prescriptions were analyzed. Of these, 2,093 (43.3%) prescriptions had at least one FDC. These 2,093 prescriptions had 366 different FDCs. Of the 366 FDCs, 241 were rational; 10 were irrational; 14 required further data generation; and the remaining 96 FDCs could not be categorized into any of the above. Vitamins and minerals/supplements, antibacterial for systemic use, and drugs for gastroesophageal reflux disease (GERD) and peptic ulcer were the most used FDCs. Conclusion: Based on the finding that some prescriptions contained irrational FDCs, it is recommended that a rigorous, regular, and uniform method of evaluation be implemented to approve/ban FDCs and that prescribers be periodically notified about the status of the bans.
ABSTRACT
This study evaluated the protective effect of ellagic acid on sodium valproate-induced sperm abnormalities in male Wistar rats. A total of 30 rats were grouped into five groups, each having 6 animals. Vehicle, sodium valproate (400 mg/kg) and ellagic acid (10, 25, 50 mg/kg) were given orally from day 1 to day 7, and ellagic acid was continued for 3 more days. On day fourteen, animals were sacrificed and the different parameters were recorded. There was a significant decrease in the sperm count and sperm motility after the exposure to sodium valproate. The percentage of abnormal sperms increased in a dose-dependent manner. The histopathological examination revealed that sodium valproate had caused degeneration and desquamation of germinal cells in the epithelium and also showed a decrease in the Johnsen’s scoring. Ellagic acid provided partial protection at the doses of 10 and 25 mg/kg and complete protection at 50 mg/kg, against sodium valproate induced testicular and spermatozoal damage.