A study on pattern of prescription of drugs in pregnancy with complications in a tertiary care teaching hospital: A cross-sectional study

Background: During pregnancy, women undergo various physiological changes and also suffer from some common illnesses like morning sickness, which may increase the prescription and use of drugs. Thalidomide tragedy of 1960 has created the concern regarding the use of medications during the pregnancy. Prescriber should be very vigilant, while prescribing the drugs for pregnant women because health of mother and fetus may be at risk. To prevent the morbidity and mortality of the mother and the fetus, safer and effective drugs have to be selected with utmost care. Aims and Objectives: Main objectives of our study were to determine the drugs used during complicated pregnancies and to assess the safety of drugs prescribed using the World Health Organization prescription indicators. Materials and Methods: After getting approval from the Institutional Ethics Committee, this cross-sectional study was carried out in the obstetric department of tertiary care teaching hospital for a period of 3 months. Case sheets of pregnant women with complications were collected and the details regarding demography and complete prescription were collected in a predesigned proforma. The data collected were analyzed using descriptive statistics. Results: Among 160 pregnant women, 71% were multigravida and most of the participants belonged to age group of 20–30 years 84% (134). Disease pattern among pregnant women in our study revealed that common illnesses complicating pregnancy was anemia (51%), followed by pregnancy-induced hypertension, oligohydramnios, and gestational diabetes mellitus. The study showed that hematinics, calcium supplements, and protein powders were the class of medications used in most of the prescriptions, and then by antibiotics, antiemetic, and tocolytics agents. Category A of food and drug administration pregnancy drug category was used more, constituting about (45.12%). No drugs from Category X and D were prescribed to pregnant women and 45% of drugs belonged to generic drug. Conclusion: Anemia was the most common condition, complicating pregnancy and common class of drug used were hematinics and protein supplements. Category A drugs, which were the safest class, were prescribed more in our study. No drugs from Categories D and X were used. This indicates that prescribers are well aware of safer drugs in pregnancy.

A cross-sectional study on knowledge and practice of over-the-counter drugs among 2nd year medical students in a tertiary care teaching hospital

Background: Over the counter drugs (OTC) are the drugs that can be sold by the pharmacist without the prescription of registered medical practitioner. There is an increase in the trend of usage of OTC drugs because of busy lifestyle which can result in adverse drug reactions, drug interaction, abuse, and misuse of drugs. Since medical students are future doctors and play an important role in educating the patients regarding benefits and risks of using OTC drugs, the present study is undertaken to assess the knowledge and practice of OTC drugs among MBBS students. Aim and Objectives: The main objectives of this study was to determine the commonly used OTC drugs and indications for the use of OTC drugs among MBBS students and to assess their knowledge on safety of use of OTC drugs. Materials and Methods: A cross-sectional, observational, and questionnaire-based study was conducted during December 2021 among 2nd year MBBS students, after getting approval from the Institutional Ethics Committee. Students were explained about the purpose of the study and questionnaire was administered to the students. The data collected were analyzed using descriptive statistics. Results: In our study, we observed that 75.3% of students practiced self-medication (SM) using OTC drugs for minor illnesses. The most common drugs used for SM were analgesics, antipyretics and antihistamines. The most common reason for using OTC drugs is due to influence from family and friends/seniors (30.2%). Conclusion: Use of OTC is widely practiced among health care professionals, since they are exposed to knowledge of drugs, from 2nd year MBBS itself. Since students are future doctors and play a very important role in communication of knowledge regarding medical therapy including use of OTC drugs to the patients, they should be educated in a larger way regarding pros and consequences of use of OTC drugs.

Partial trisomy of chromosome 10 inherited from a carrier father.

Partial trisomy of chromosome 10q is a very rare condition with only four cases having been reported int he literature. This report describes a neonate with symmetric growth retardation and multiple dysmorphic features, in whom G-banded chromosomal analysis revealed a partial trisomy of chromosome 10q (q2.4-q ter). The father was diagnosed as a carrier of a balanced translocation with a karyotype of 46, XY t(10.3) (q2.4L : pter). In patients with a bad obstetric history, genetic counselling prior to a new conception cna aid in early prenatal diagnosis of fetuses with recurrent chromosomal abnormalities by means of fetal tissue sampling.

KAP study on mothers of children with Down syndrome.

We evaluated 50 mothers of children with Down syndrome attending Genetic Clinic of the Institute of Child Health and Hospital for Children, Madras, with special reference to their knowledge, belief and attitudes in the care of these children. After evaluation, they were educated individually and in groups with demonstration, picture cards and pamphlets, on the causation, expected health problems, developmental potential of Down syndrome and the ways and means to help the child to attain the maximum developmental potential. They were taught on preventive aspects of Down syndrome as well. Re-evaluation was done after three months, and considerable improvement was noted in the mother's knowledge, and attitude towards bringing up such a child. The mothers also showed an improvement in the skills in providing developmental enrichment to these children. Thus this study has formulated a programme in the management of such children, which can be practised on any population, anywhere, especially, in rural areas, and by less affluent folk, with poor educational background.

Anthropometry for syndromology.

In diagnosing certain syndromes, abnormal facial features such as hypertelorism, low set ears or wide nasolabial distance are taken into consideration. Most often the description is from a visual impression, which may prove wrong as it is only relative. Detailed studies have, so far been only from the west, except for two, from northern India. These values may not suit us as facial features and measurements vary in different populations. This study was undertaken to set up a standard for the south Indian population, to detect deviations and to compare our figures with those from other studies. Measurements were taken in 850 children, from birth to 11 years of age (horizontal study). The parameters studied were the inner and outer canthal distances, from which interpupillary distance was calculated; nasolabial distance, ear length, ear set, hand length and AF/AT ratio. The average measurements for various features (50th percentile) 3rd and 97th centile are presented in tables. Besides providing standards, this paper will aquaint the pediatricians on the need to actually measure the features rather than rely on ones impression on physical features in diagnosing syndromes.

Translocation Down's syndrome.

Among the 500 Down syndrome children karyotyped, 15 (3%) were due to translocation; 10 were 21;21 translocation and five 14;21. There were 9 cases of de novo translocations, while 6 were inherited from father or mother. Family history was characteristic in all the translocation cases, with younger parental age, fetal wastage in the family, recurrence and with the affected child often being either the first or the only liveborn in the family. The pattern of translocation in Madras and the significance of family history in genetic counselling are discussed.