ABSTRACT
Objective: This study was conducted with the aim to evaluate the efficacy and safety of Vitamin B complex as an add-on therapy to diclofenac in patients with primary osteoarthritis (OA) of the knee. Materials and Methods: In this prospective, open-labeled, randomized, and comparative clinical study, a total of 130 patients of age >40 years with primary OA of knee attending orthopedics OPD were randomly allocated into two groups of 65 each, i.e., Group D and Group B. In Group D, patients received tablet diclofenac 75 mg and in Group B, patients received tablet Vitamin B complex along with diclofenac once daily for 4 weeks, respectively. Clinical assessment was done at baseline and at the end of 4 weeks and 8 weeks by the visual analog scale (VAS), WOMAC index, and Lequesne index. Results: During the intergroup comparison, it was found that Vitamin B complex as an add-on therapy to diclofenac produced statistically significant reduction in mean VAS pain score (P < 0.05). However, the difference in mean WOMAC index and Lequesne index was not statistically different at 4 and 8 weeks between the two groups (P > 0.05). Mild side effects were seen at 4 weeks, but no side effects persisted up to 8 weeks in both the groups. Conclusion: The present study suggested that Vitamin B complex as an add-on therapy was found to cause a significant reduction in pain score. It could be a promising drug in patients with OA to improve the analgesic effect, when combined can reduce the dose of diclofenac, thereby minimizing the side effects.
ABSTRACT
Background: Altered hepatic, renal and GIT function along with multiple comorbidities makes use of certaindrugs inappropriate in geriatric population. Identification and rectification of mistakes and lacunae in thecurrent prescribing pattern is crucial for ensuring appropriate and rational prescribing. Purpose: To study theprescribing pattern and medication inappropriateness in geriatric patients in a tertiary care teaching hospital.Material and Methods: Details of the prescribed drugs were obtained from the files of the 60 hospitalisedgeriatric patients and the prescribing pattern was studied. Medication inappropriateness was assessed and theinappropriate drugs were classified into various categories using Beers criteria given by American GeriatricSociety. Number of prescriptions having potential for drug interactions was also calculated. Results: Averagenumber of drugs per prescription was 7.7 with antibiotics being the most commonly prescribed drugs.49.13% were prescribed by brand names. 12.12% drugs were prescribed inappropriately and 20% prescriptionshad one or more inappropriate drug. Potential drug-drug interactions that should be avoided in older adultswere found in 11.6% prescriptions. Conclusion: A considerable fraction of the prescriptions of geriatricpatients were inappropriate and incidence of polypharmacy was very high. There is a pressing need to educatethe physicians about the mistakes in the prescribing pattern of geriatric patients and the adverse effect it canhave on the health of these patients.
ABSTRACT
Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’sexpertise. Analysis of quality of prescriptions can be carried out by various methods and by using certain toolsas well. Prescription Quality Index (PQI) is one such validated tool for analyzing the prescription quality. Thepresent study was undertaken on 2155 prescriptions to analyse the prescriptions of outdoor patients by usingPrescription Quality Index tool. Each prescription was evaluated by using questionnaire of PQI tool. The toolconsists of 22 questions, based on the answers of which a score was calculated for each prescription. Thena collective mean score for all the prescriptions was calculated. Depending upon individual scores, theprescriptions were graded in to poor, medium and high-quality prescriptions. The mean PQI score for all the2155 prescriptions was 28.94 ± 0.23. We found that 1015 (46.10 %) prescriptions were of poor quality, 46(2.13 %) were of medium quality and 1094 (50.77 %) were of good quality. The overall mean score of all theprescriptions falls in to the poor-quality prescription category according to PQI. It was concluded that therewere many lacunas that require the attention of prescribers in order to attain and maintain high standardprescription quality.
ABSTRACT
Background: Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’s expertise. World Health Organization has defined certain parameters to promote rational drug use in all countries. This study was designed to assess the prescription writing practices in a government tertiary care hospital in Haryana by using WHO prescribing indicators.Methods: A total of 2155 prescriptions were evaluated. Each prescription was evaluated for average number of drugs prescribed per patient per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of medicines from Essential drug list prescribed. These indicators help us to check polypharmacy, practice of prescribing drugs by brand names, antibiotic overuse, preference of injectables and non-adherence to Essential drug list.Results: The average number of drugs prescribed per patient per encounter was calculated to be 3.25±0.24. The percentage of medicines prescribed by generic names was 35.89%. Percentage of encounters with an antibiotic prescribed was 48.21 % and with an injection prescribed was 1.85%. The percentage of medicines form NLEM was 76.36%.Conclusions: The values of WHO prescribing indicators obtained from this study show that there are some areas where the prescribers need to improve their prescribing practices.
ABSTRACT
Healthy adults were screened for 25(OH)D by Enzyme linked immunoassay method. Those found to be deficient or insufficient in vitamin D (defined as 25(OH)D <30 ng/ml) were supplemented with oral vitamin D granules 60,000 IU/week for eight weeks. Serum 25(OH)D level was 3 estimated at the end of 8 weeks. Results: A total of 100 subjects (age 20-50 years) were enrolled for the study. Baseline data and follow up data was available for 90 subjects who consumed a total of eight sachets as per the study protocol. Of these 90 subjects, 91% subjects were found to be vitamin D deficient (<20 ng/ml) , 8.89% were vitamin D insufficient and 0.11% were vitamin D sufficient. The mean plasma vitamin D 25(OH)D level was 12.43 ng/ml (±4.29) at baseline. At the end of the study, the mean 25(OH)D plasma level was noted to be 46.34 ng/ml (±13.57). The mean change from baseline was 23.91 ng/ml (±13.25). Conclusion: This study showed that vitamin D deficiency is highly prevalent in the urban healthy adult population. Eight weeks of vitamin D3 60,000 IU/week oral granules supplementation increased serum 25(OH) D to optimal levels.