ABSTRACT
Background: Hypertension is one of the primary modifiable risk factors for cardiac and renal diseases and is the single most important risk factor for stroke. Despite different guidelines for management of hypertension like Joint National Committee, British Hypertension Society, National Institute for Health and Care Excellence; there are still the clouds of controversy. The objective of the study was to evaluate the prescribing pattern of antihypertensive drugs among the patients attending medicine outpatient department of a tertiary care teaching hospitalMethods: A cross-sectional, observational study was conducted in our hospital over a period of six months. Relevant information was collected from medical records of 209 hypertensive patients fulfilling inclusion criteria. The collected data were sorted and analyzed.Results: Out of 209 patients, maximum were of age group of 45-65 years (55.02%). 115 (55.02%) were male and 94 (44.97%) were female. Diabetes mellitus (24.4%) was the most common associated disease with hypertension. Most of the patients had received single antihypertensive drugs (49.28%). Among the monotherapy category calcium channel blocker (82.78%) was the most commonly prescribed antihypertensive drug class followed by angiotensin receptor blocker (36.36%). Amlodipine (81.82%) was the most common among calcium channel blockers. The most frequent fixed drug combination prescribed consisted of amlodipine and atenolol. Most of the drugs were prescribed in generic name (90.9%).Conclusions: The treatment pattern, in general, conformed to standard treatment guidelines.
ABSTRACT
Background: Allergic rhinitis is a common disorder characterized by sneezing, rhinorrhoea, nasal congestion, itching and lacrimation which adversely affect quality of life to a substantial degree. Evidence suggests that low serum vitamin D3 has correlation with severity of allergic rhinitis. The objective of the study was to evaluate whether vitamin D3 supplementation has any role to reduce the severity of disease spectrum among allergic rhinitis patients.Methods: This prospective analytical observational study was carried out in 6 months in ENT OPD of Midnapore medical college and Hospital. Only the persistent moderate to severe allergic rhinitis patients as per ARIA-WHO guideline, aged >12 years were included in this study. 64 subjects were randomised into two groups. The test group received oral vitamin D (60000 IU/week for 2 months) along with levocetirizine, fluticasone spray and montelukast while the control group received three drug therapies without vitamin D3. Allergy symptom score (ASS) was assessed at the start and end of the study period.Results: The study population (n=64) was predominantly female (37) and had a mean age of 39.79 years. The ASS score was 14.06�01 in Test group and 13.93�01 in Control group and the Post treatment ASS score was 2.65�12 and 6.06�87 respectively. This difference between groups was significant (p<0.001).Conclusions: There was significant reduction in the Allergy symptom score after vitamin D3 supplementation which alters the course of disease towards clinical improvement.
ABSTRACT
Background: Bronchodilators and glucocorticoids have been proven to be very effective and safe in asthma treatment, which recommend the use of steroids and β2-agonist (long or short acting) as the first line of treatment in of asthma. This study was aimed to compare the efficacy of three different inhaled corticosteroids ciclesonide, budesonide, and fluticasone in bronchial asthma. Methods: A total of 30 patients with mild to moderately persistent bronchial asthma was selected as per the NAEPP classification in the expert panel report (EPR) update 2002, NHLBL USA 2003. They were randomly divided into 3 groups of 10 patients each, and they were given 3 different steroid inhalers (ciclesonide or budesonide or fluticasone). Baseline and post-therapy spirometry were performed on day 1 and after 2 months and 6 months of treatment. Data were analyzed using SPSS software. Results: It was observed that most of the cases (43.3%) were between 26 and 35 years of age with female preponderance (56.6%). Significant symptomatic improvement was observed in all 3 groups. The percentage of improvement in mean peak expiratory flow rate was 17%, 18%, and 18% in ciclesonide, budesonide, and fluticasone group, respectively. The percentage improvement of forced expiratory volume in 1 second (FEV1)/forced vital capacity after bronchodilatation was 18%, 18%, and 19% in ciclesonide, budesonide, and fluticasone group, respectively. The improvement in mean FEV1% predicted was 20%, 19%, and 21% in three groups, respectively. Conclusion: Steroid therapy along with β2-agonists showed a significant improvement in symptoms. There was no difference among the three different types of steroids.