ABSTRACT
Background: The emergence of antimicrobial resistance is a worldwide challenge threatening to negate the gains made by discovery of antimicrobial agents (AMAs). Antimicrobial Stewardship Program (ASP) is an important strategy for ensuring appropriate use of AMAs and controlling emergence of antibiotic resistance. Implementation of ASP must start with assessment of the current state of antimicrobial use. This study was therefore conducted to assess the prevalent prescribing patterns in a tertiary care hospital and identify gaps which warrant corrective intervention.Methods: This prospective pilot study presents analysis of the first 30 Patients from the medicine ward prescribed at least one antimicrobial agent during the two months of study period. Relevant data was collected in AMA record form. Appropriateness of AMAs was analyzed regarding selection as well as administration protocol as per the hospital antibiotic policy.Results: Out of the 60 AMAs prescribed to these patients, most commonly prescribed were cephalosporins (63.3%), anti-amoebics (26.6%) and macrolides (23.3%). Common diseases involved were urinary tract infection, acute gastroenteritis, sepsis and lower respiratory tract infections. Use of AMAs was found to be appropriate for the indication in 42 %, dose in 97%, duration 60 %, route 93% and frequency 90 %.Conclusions: This gap between the appropriate and the actual practice use of AMAs indicates an urgent need of rigorous implementation of ASP in order to avoid emergence of resistance and to conserve the sensitivity to the available AMAs.
ABSTRACT
Background: Prescription practices should be good so that they are correctly interpreted and medications are used or administered accordingly. Studies are found usually focusing on WHO prescribing indicators in various healthcare set-ups. This prescription audit study was conducted to analyse the prescription practices in a tertiary care hospital and see the influence of various interventions on these practices.Methods: It was a quality initiative undertaken to retrospectively assess and evaluate the change in the prescription writing practices in the in-patient department of a tertiary care teaching hospital from March 2017 to April 2018. Number of interventions were conducted to meet the compliance of prescription parameters during the study period and prescription parameters was analysed again thereafter for one-year to see the change.Results: An overall increase in compliance of prescription parameters was found from 67.3% in March 2017 to 94.8% in June 2017. Thereafter this was consistently maintained upto 91% during the study period. Most of the prescription parameters were seen to be improved like allergy history taking from 52.2-95.6%; mention of prescriber’s name, sign, registration number from 53.5-86%; consideration to food-drug interaction from 28.7-99.5%.Conclusions: Prescription writing practices were quite poor initially which improved after various interventions were carried out in the study area.
ABSTRACT
Background: Antiviral drugs for viral infections other than HIV are effective only for hepatitis, herpes and influenza. It has been observed that general practitioners (GPs) treat viral infections with antibiotics. The use of antibiotics in viral infections is not rational. Hence, authors conducted this study to assess the Knowledge, Attitude and Practices of General Practitioners (GPs) about treatment of viral infections other than HIV.Methods: It was a descriptive, observational, cross- sectional study among 100 GPs in Southern Pune. A pretested questionnaire was used to assess their knowledge, attitude and practices about treatment of viral infections other than HIV. Prior informed written consent was taken from the GPs who were grouped under MBBS, BHMS and BAMS categories according to their qualifications. Correct answers among these groups were analysed using chi-square test, Spearman’s coefficient test and ANOVA.Results: The percentages of correct answers in the groups were comparable.56% GPs have poor knowledge of Influenza treatment.30-36% do not treat Herpes genitalis and zoster with antiviral drugs. Authors found that 44%, 30% and 28% of total GPs don’t have proper knowledge, attitude and practice respectively about common viral infections other than HIV and antiviral drugs.Conclusions: GPs are significantly unaware about rational use of antiviral drugs. They have poor knowledge about management of influenza.
ABSTRACT
Background: Hepatotoxicity by chemicals and drugs is a common clinical problem. Presently very few drugs are showing effectiveness in prevention and treatment of hepatic damage. So in this study, we evaluated the role of trimetazidine in carbon tetrachloride (CCl4) induced liver damage in rats. Objective of current study is to evaluate effects of prophylactic trimetazidine against carbon tetrachloride induced liver damage in rats. Methods: Liver damage was induced in 30 albino rats by CCl4 (0.5 ml/kg, i.p.) once daily for 7 days. Extent of damage was studied by assessing biochemical parameters (SGOT, SGPT, ALP, proteins and bilirubin). These biochemical observations were supplemented by pentobarbitone Sleeping Time and Histological Examination of liver. The effect of co-administration of trimetazidine (doses 5 and 10 mg/kg p. o.) on the above parameters was investigated. Liv.52® was used as Positive Control. Data was analyzed by one way ANOVA, followed by Dunnett's test. Results: Trimetazidine significantly prevented CCl4 induced elevation of serum SGOT, SGPT, ALP and bilirubin (total and direct), and reduction in protein level. Pentobarbitone sleeping time and histological examination of the liver showed consistent results. The results were comparable to that of Liv.52®. Conclusions: Trimetazidine, when administered prophylactically, shows hepatoprotective effect against CCl4 induced liver damage.
ABSTRACT
Background: To study extent of cognitive impairment by epilepsy & antiepileptic treatment and evaluate the role of piracetam on it. Methods: 48 animals were divided into 6 groups: I-Control, II- Topiramate, III-Topiramate+Piracetam, IV-Valproate, V-Valproate+Piracetam, VI-Piracetam. Baseline cognitive functions were measured using Cook’s pole climbing apparatus (CPCA) and Elevated plus maze (EPM). In CPCA, on completion of training, number of avoidances (NOA) out of 10 trials were noted while in EPM, transfer latency (TL) was measured. Kindling was induced by 30mg/kg Pentylenetetrazol (PTZ), i.p. to all groups (except Group I) on alternate days till seizures developed. Groups were treated with respective drugs orally for 21 days and cognitive functions measured again. Results: Significant decrease in NOA & increase in TL was observed after PTZ kindling. Topiramate further significantly impaired NOA and TL whereas Valproate significantly reduced NOA in CPCA but increase in TL was not significant. Treatment with Piracetam significantly increased Topiramate, Valproate and PTZ kindling induced decrease in NOA as also significantly reduced Topiramate and PTZ kindling induced increase in TL. Conclusion: Seizures are associated with cognitive impairment. Cognitive impairment caused by Sodium valproate differs from Topiramate. Piracetam, a known nootropic can be used in alleviating cognitive impairment associated with epilepsy & chronic antiepileptic therapy.