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Background: There are multiple protocols currently being followed worldwide for effective management of COVID-19 depending on the disease severity as a consequence, of which the prescribing patterns and therapeutic choices still remain unclear. Drug utilization studies provide insight into the current prescribing practices and help us in facilitating the rational use of drugs. Aim and Objectives: The aims of this study were to evaluate utilization pattern of medications used to treat COVID-19 in hospitalized patients with moderate disease as defined by Indian Council of Medical Research (ICMR) guidelines. Materials and Methods: Hospital-based prospective, observational, and cross-sectional study was conducted in Designated COVID Hospital, Bidar Institute of Medical Sciences, Bidar for 4 months from March 1, 2021, to June 31, 2021. Data were collected from patients, every 10th inpatient was randomly selected. Rationality of prescriptions was evaluated using the WHO core drug prescribing indicators. A total of 234 hospitalized patients aged more than 18 years with laboratory confirmed COVID-19 of moderate severity according to ICMR guidelines were included in the study. Results: In our study, we found average number of drugs per encounter as 7.29. Percentage of drugs prescribed by generic name as 89.05%. Percentage of encounters with antibiotic as 96.58%. Percentage of encounters with an injection prescribed as 100%. Percentage of drugs prescribed from essential drug list as 83.25%. Conclusion: Drug utilization in COVID-19 is diverse and is in accordance with the existing guidelines. Medications used are highly corresponding to the disease severity. Polypharmacy detected, here, is not irrational as it suppressed the COVID-related mortality. Steroids, anticoagulants and oxygen being the key determinants.
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Background: Adverse drug reactions (ADRs) constitute a major clinical problem in terms of human suffering and increased health-care costs all over the world. Pharmacovigilance is the science and activities relating to the detection, assessment, understanding and prevention of adverse effects, or any other drug related problems. Thus, the information generated is useful in educating doctors about ADRS as well in the official regulation of drug use. However, the pharmacovigilance program faces the challenge of under reporting of ADRs and one needs to find the ways to overcome it. Aim and Objectives: The aim of the study was to improve the reporting of ADRs from the hospital and overcome the problem of under-reporting of ADRs. Materials and Methods: A prospective observational study was conducted as part of pharmacovigilance program over 6 months between June 2021 and December 2021. Undergraduate students were trained to collect cases of ADR from hospital during their clinical postings. The details of cases obtained by such active surveillance were filled into suspected ADR–CDSCO forms and submitted to pharmacovigilance unit. Causal relationship was assessed and categorized by Naranjo algorithm and WHO-UMC causality scale. All values were expressed in percentages. Results: A total of 120 cases were reported over 6 months compared to just 20 cases during the past year. Among them, 66% were in males and 55% were in females. The majority of ADRs were due to antimicrobial agents (40.78%) followed by hematinics (12%) and anti-epileptics (10%). The maximum number of patients (30.25%) reported with dermatological manifestations. The highest number of ADRs was reported from the Department of Medicine (45%). As per Naranjos scale, 54% reports were assessed as probable and 46% as possible. Conclusion: This new way of training and involving undergraduates significantly improved the number of ADR cases being reported to the pharmacovigilance center. This helped overcome the problem of under reporting of cases and has strengthened the pharmacovigilance activity in our institute.
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Objective: To assess the clinical features of SpA including BATH indices and to compare clinical data of male and femalespondyloarthropathy patients.Methods: The study included male and female patients (60 each) fulfilling the European Spondyloarthropathy StudyGroup (ESSG) or assessment of ankylosing spondylitis (ASAS) criteria for SpA and the CASPER criteria for PsA or themodified New York criteria for AS. The subjects completed initial clinical evaluation and radiological and laboratoryassessment.Results: The mean age of presentation was found to be higher in females (34.6± 9.6 years). Backache was the mostcommon features identified in both the groups. Peripheral arthritis was present in 51.7% of total patients (56.7% malesand 46.7% females). Asymmetrical lower limb arthritis was found to be more predominant; however, 10% of the patientsreported involvement of wrist. Psoriasis and inflammatory bowel disease, and uveitis were noted in 13 (7 males and 6females), three (1 male and 2 females) and 14 patients (9 males and 5 females) respectively. Dorsal and neck pain werefrequently prevalent among the patients.Conclusion: Though the severity of symptoms and disability are comparable across both the genders, females haveincreasingly been diagnosed with SpA. Most common symptom of presentation is low back pain followed by gluteal pain.Peripheral arthritis, predominantly lower limb oligoarthritis is common in Indian population when compared to theirwestern counterparts.
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Background:In Critical care units, prediction of outcome is of vital importance to the clinician. It allows planning of early therapeutic intervention and appropriate counseling of patient.So sensitive, inexpensive and dynamic prognostic markers which generate rapid and reliable results are therefore desirable in the ICU setting. Objectives: 1.‟ To evaluate microalbumin to creatinine ratio within 6 hours of ICU admission and after 24 hours of ICU admission. 2. To correlate microalbumin to creatinine ratio with APACHE II score to predict outcome in critically ill patients”. Methods: In this prospective non-interventional study, 98 adult patients admitted to I.C.U. with more than 24 hours of ICU stay were included and Spot urine sample collected at 6, 24 hours of admission to medical ICU ward. Sample will be tested for urine microalbumin by immunoturbidometric method and urinary creatinine was measured by calorimetric method. Albumin: creatinine ratio was measured. For disease prognosis scoring, GCS, SOFA and APACHE II scores were calculated simultaneously. Results:Prevalence of ACR at 6 hrs 95.7%, 97.9% at 24 hrs. Out of 98 patients 47 patients died.p value <0.001. Among the survivors there was a significant correlation between decreasing microalbuminuria, microalbumin to creatinine ratio level and decreasing APACHE II and SOFA scores, and increasing GCS score, p- value being 0.0011, 0.002 and 0.0005 respectively. Among the non-survivors there was a significant correlation between increasing microalbuminuria, to creatinine ratio level and increasing APACHE II and SOFA scores, and decreasing GCS score, p value being 0.0001, 0.0001 and 0.0001 respectively.Conclusion: This study was carried out to find out the role of microalbuminuria, microalbumin to creatinine ratio as a predictor of prognosis in critically ill patients as compared to standard scoring methods like the Glasgow coma scale, APACHE II and SOFA scores. Hence microalbumin to creatinine ratio at 24 hours may be considered as a predictor of outcome in critically ill patients.
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The anti-malarial activity of Eclipta alba leaves extract was evaluated against Plasmodium'berghei ANKA strain in mice. A standard inoculum of 1 x 10(6) infected erythrocytes was used. The methanolic leaf extract (250-750 mg/kg) produced a dose-dependant chemosupression or schizontocidal effect during early and established infection and high mean survival time (m.s.t.) values particularly in the group administered 750 mg/kg/day of extract. The plant extract also exhibited repository activity. The results of the preliminary studies carried out with E. alba are encouraging, which can be exploited in malaria therapy.