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Background: Upper respiratory tract infections are mostly caused by viruses and are self-limiting. But it is seen that drug therapy is restored to many of them without adequate justifications. Sometimes multiple drug therapy imposes high cost burden on patients. Use of antibiotics in URTI patients have led to rise in bacterial resistance. So, this study was aimed to analyse the prescription pattern in upper respiratory tract infections and the antibiotic susceptibility of the isolated organisms.Methods: An observational cross-sectional study was conducted in a tertiary care hospital for a period of three months. Based on the inclusion and exclusion criteria sixty patients were selected. Prescriptions of these patients were collected and analysed for the various WHO prescription indicators like average number of drugs per encounter, percentage of drugs prescribed by generic names, percentage of drugs prescribed as injection, drugs form the essential drug list etc. The swabs were collected from the site of infections and were analysed for the bacterial growth. Also, the antibiotic susceptibility of these organisms was tested.Results: A total of sixty prescriptions were collected and analysed. The average number of drugs per prescription was 2.21. Antimicrobials were prescribed in 90% of cases. Approximately 50% cases the combination of amoxicillin and clavulanic acid was prescribed. The percentage of drugs prescribed by generic names was 87% and 68% drugs were form the essential drug list. The culture report of the specimen collected from the swabs showed that only 50% of cases were of some bacterial origin. And the organisms isolated were less susceptible to the antibiotics that were prescribed.Conclusions: This study of prescribing patterns in patients gives appropriate feedback and awareness among health care providers. Rationale prescribing practice will prevent antibiotic resistance and reduction in the adverse drug reactions.
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Background: The prevalence of coronary artery disease has been increased in diabetic dyslipidemia; hence the present study would like to compare the dyslipidemic effects of Sitagliptin, Voglibose, and Glimepiride in combination with Metformin in type 2 diabetes mellitus patients.Methods: This study was a Prospective, Randomized Clinical trial conducted at SRM medical College Hospital and Research centre. Potheri, Kancheepuram District in diabetic outpatient department after obtaining approval from Institutional Ethics Committee. The patients receiving antidiabetic drugs were divided into three groups. Patients received Metformin with Sitagliptin were grouped as I, Metformin with Voglibose were named as Group II and Metformin with Glimepiride were marked as Group III. Based on the inclusion and exclusion criteria, in each group, 40 patients were assigned as per simple randomization method. The level of lipid profile and BMI was evaluated at the end of 6 months.Results: There was a significant reduction of Total Cholesterol (TC) in Group II and Group III (p value- <0.001, <0.006). Group I showed significant elevation of HDL-C level with the p value of <0.03. Group III showed significant reduction of Triglyceride (TG) level with the p value of <0.04, significant reduction of Low Density Lipoprotein Cholesterol (LDL-C) level with the p value of <0.02 and significant reduction in Very Low Density Lipoprotein Cholesterol (VLDL-C) level with the p value of <0.05. There was no significant reduction in Body Mass Index (BMI) among the groups. On multiple comparisons, Group III showed higher efficacy in reducing TC, TG, LDL-C and VLDL-C levels.Conclusions: The results of this study were analysed and it could be concluded as Metformin with Glimepiride combination (Group III) showed significant reduction of TC, TG, LDL-C and VLDL-C levels.
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Background: Adverse Drug Reactions (ADR’s) contributes to the burden of drug-related morbidity and mortality. ADRs are seen frequently in hospitals due to a variety of factors like complexity of diseases, drug interactions, polypharmacy, and possible negligence. The purpose of the study was to identify and assess ADR in various departments of a tertiary care teaching hospital.Methods: A prospective spontaneous reporting was carried out in a tertiary care teaching hospital during a period of four months from November 2016 to February 2017. All suspected spontaneous ADRs were assessed and the information was collected and analyzed by the pharmacologists for causality assessment using the Naranjo’s causality assessment scale.Results: A total of 30 ADRs were reported with female preponderance (70%). Majority of ADRs were from General Medicine and Oncology departments. The most affected organ systems were skin (80%) followed by the gastrointestinal system (13.3%). The most frequent drugs causing ADRs were antibiotics (56.3%) in which type B reactions were more compared to type A and followed by anticancer drugs (10%). The severity assessment showed that most of them were mild reactions (76.6%). Causality assessment revealed that 90% of the reactions were probable, 10% were possible and no reactions were unlikely.Conclusions: The study accomplished that ADRs are widespread and a few of them raised the healthcare expenditure due to increased hospital stay. The reporting of the ADRs to regional Pharmacovigilance centers should be encouraged to ensure drug safety.
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Background: Ischemic heart disease is the most common cardiovascular disease in developed countries such as United States and Angina pectoris is the most frequent among them. If not managed adequately angina results in significant morbidity and mortality too due to the complications. Antianginal therapy is lifelong. Therefore, analysis of the price of drugs used in ischemic heart disease will help to improve patient compliance. Methods: Prices of various antianginal drugs of different strengths and combinations marketed by different companies was obtained from current index of medical stores. The variation between highest and lowest price of the same medication manufactured by various pharma companies and percentage variation in price for ten tablets was calculated. Results: In India, percentage variation in price for antianginal drugs was found to be: tablet isosorbide dinitrate (5 mg) 250%, glyceryltrinitrate (6.4 mg) 24.44%. In calcium channel blockers group, tablet amlodipine 10 mg shows maximum price variation of 1045%, closely followed by 5 mg of amlodipine with a variation of 1040%, while 120 mg of diltiazem shows the least variation of 262%. In betaadrenergic receptor blockers group, tablet atenolol 50 mg shows maximum price variation of 563%, whereas 100 mg of extended release metoprolol shows the least variation of 42%. Conclusions: To increase the benefit to the patient and reduce drug in compliance, doctors should be trained to be familiar from internship period itself about the brand names of cost-effective drugs with good safety profile for a long period.
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Background: Antibiotics are commonly used in pediatric illness and irrational use of antibiotics can lead to bacterial resistance. Appropriate studies should be done to frame proper guidelines for the use of antibiotics in pediatric population. The objective of the study was to determine the prescribing pattern of antibiotics and to analyze the rational use of antibiotics in pediatric department. Methods: An observational prospective study was carried out for a period of 3 months in the Department of Pediatrics. The data were recorded in the specific format, and the result was analyzed by descriptive statistics. Results: In this study, 347 prescriptions containing antibiotics were analyzed, out of which 54.6% were of male child and 45.4% were of female child. About 40.6% of the patients were in the age group of 1-5 years. A single antibiotic was prescribed in 78% of patients. Respiratory tract infections were the most common disease (68.2%), followed by skin infections (12.3%), gastrointestinal diseases (9.5%), and fever without focus (6.5%). Cephalosporins were the most commonly prescribed antibiotic group (35%). Conclusion: Irrational use of antibiotics can lead to bacterial resistance and can worsen the existing disease conditions. So, antibiotics should be prescribed according to the WHO guidelines or other rational strategy, especially in the pediatric age group.
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Medical fraternity believed that Vitamin D deficiency is rare in southern part of tropical country like India. This study is aimed to determine the serum vitamin D, calcium, phosphorus and alkaline phosphatase levels in healthy subjects around Potheri, kancheepuram district of Tamilnadu. Total of 81 subjects above the age of 20, out of which 50 males and 31 females were recruited for the study. Institutional ethical committee clearance was obtained. After getting informed consent from each subject, a preformed questionnaire containing the details about socioeconomic status, religion, dietary habits , sun light exposure and skin color were filled. Venous blood was drawn to test vitamin D, calcium, phosphorus and alkaline phosphatase levels in the serum. Among 81 subjects, 73.91% had Vitamin D deficiency. Serum Vitamin D was not significantly correlated with serum phosphorus, serum alkaline phosphatase, skin color and living condition. But there exists positive correlation between serum calcium, sun light exposure with Vitamin D levels whereas socio economic status had a negative correlation. Adequate sun light exposure, fortification of food and oral intake of 800IU-1000IU Vitamin D daily are the best options to combat the Vitamin D deficiency.
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Background: Pain is the most common symptom for which patients approach doctors. We have multitude of drugs for pain relief, but they have serious side effects ranging from peptic ulcer (e.g. NSAIDs) to renal failure. The other group, opioids have well known side effects ranging from sedation to drug dependence. So a search for a drug for analgesia with high therapeutic effect and fewer side effects will be a boon for the patients. The objective of this study was to find whether cetirizine, a second generation antihistaminic drug, has got any analgesic activity in mice. Methods: Ten adult albino mice weighing 20-30 grams of either sex were randomized to two groups (n=5). Group I: control group (Treated with solvent 0.1 ml/kg), Group II: Test group (Cetirizine 1mg/kg). All drugs were given orally. The analgesic activity was evaluated by using tail flick, tail immersion and tail clip methods. Reaction time of animals to pain sensation before and after Cetirizine administration were noted at 0, 15, 30, 60 and 90 minutes time intervals respectively on Day 1, 3, 5, 7, 10. Results: Mean reaction time was expressed as Mean±SEM, and one way ANOVA was used to assess statistical significance. Cetirizine was found to have statistically significant analgesic effect in mice and time dependent increase in analgesic effect were observed in all three pain models and maximum analgesic activity was observed at 60 minutes (p<0.001) after drug administration. Conclusions: Through this study, Cetirizine, a second generation antihistamine, is found to have significant analgesic activity in mice. This effect has to be studied further elaborately in animals as well as in humans.