ABSTRACT
Introduction: Diabetes mellitus frequently leads to development of peripheral neuropathies in almost 30-50% of patients and the most common type of neuropathy associated with this condition is Distal Symmetric Sensorimotor Polyneuropathy (DSPN). Gabapentin and Amitriptyline are two drugs frequently used for the treatment of neuropathic pain associated with type 2 diabetes. Aim of the study: The aim of this study was to compare efficacy and safety of Gabapentin and Amitriptyline in subjects of Type 2 diabetes mellitus with peripheral neuropathic pain. Material and Methods: A prospective, open, randomized, parallel group, comparative study was conducted in 60 patients coming to Department of Medicine, Rajindra Hospital attached to Government Medical College Patiala, to evaluate the efficacy and safety of Gabapentin and Amitriptyline in patients with diabetic peripheral neuropathic pain. The patients fulfilling the inclusion criteria were included in the study after taking written informed consent. The patients were divided into two groups of 30 cases each by simple randomization. Group I patients received Gabapentin 300 mg HS by oral route. Group II patients received Amitriptyline 25 mg HS by oral route. Therapeutic efficacy of both drugs, by using Michigan Neuropathy Screening Instrument (MNSI) was compared at the baseline and at the end of 4 months. Any adverse drug reactions of the respective drug observed in patient were also noted. All the observations thus made were statistically analysed using appropriate tests. Results: Baseline characteristics of the patients in two groups such as age, sex, duration of diabetes were similar (p>0.05). The mean age in group I and group II were 53.40±8.41 years and 57.17±8.55 years, respectively. There was statistically significant reduction in mean MNSI scores in questionnaire part and physical examination part in both the groups. Also, there was statistically significant difference between the two drugs in reducing mean MNSI score. Mean difference between two drugs in reducing MNSI score in history part (0.77±0.16, p<0.01) and physical examination part (0.75±0.19, p<0.01) favoured Gabapentin. No. of adverse drug reactions reported were significantly higher in Amitriptyline group, p value (<0.05) for the difference in ADRs between two drugs was statistically significant. Conclusion: In this study, we concluded that both drugs lead to improvement in signs and symptoms of diabetic neuropathy. Gabapentin was proved to be more efficacious than Amitriptyline. Gabapentin treated patient’s mean MNSI score at the study end point was significantly lower as compared to the Amitriptyline treated patient’s end-point score. Adverse drug reactions reported in our study were mild in both the groups and a significantly higher number of adverse effects were reported in the amitriptyline group. Dizziness and somnolence were two most commonly reported adverse drug reactions.
ABSTRACT
Aim: A pharmacoeconomic analysis to determine the relative cost-effectiveness of timolol 0.5%, brinzolamide 1% and brimonidine 0.2% eye drops in treatment of Primary Open Angle Glaucoma (POAG)/ocular hypertension (OHT). Settings and Design: Comparative, open, randomized, parallel group prospective study. Materials and Methods: 60 patients of POAG or ocular hypertension were included in this study. Time period of study was 6 weeks. 60 eyes of 60 patients were included in the study. Patients were divided randomly into 3 groups of 20 each. Patients in group A, B and C received timolol, brinzolamide and brimonidine respectively. One drop of each medication was instilled twice a day at 9 am and 9 pm daily for 6 weeks. IOP was measured on day 0 at 9 am (before administration of drugs) and then at 11 am, to get baseline IOP. IOP was again measured on subsequent visits at 9 am and 11 am. Treatment outcome was number of mm Hg fall in IOP induced by the study drug. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost‑effectiveness was then calculated as the cost of drug/mm Hg fall in IOP. Statistics: Paired ‘t’ test was used to analyze the parameters within the group. Independent samples t‑test was used to compare the efficacy of drugs with each other. Results: The % reduction of brimonidine, timolol and brinzolamide at end of 6 weeks was 21.43 ± 3.06%, 24.87 ± 2.46% and 18.78 ± 1.73% respectively. Timolol was superior in efficacy to other two drugs. The difference was statistically significant between the efficacy of timolol and brinzolamide (p < 0.001) as well as timolol and brimonidine (p = 0.003). There was no statistical significant difference in the efficacy of brimonidine when compared to brinzolamide (p=0.26). Timolol (5.87 ± 0.83 Rs/mm lowering after 6 weeks) was found to be most cost-effective followed by brimonidine (46.83 ± 7.37) and then brinzolamide (60.49 ± 6.77) in lowering IOP. Conclusion: All three drugs under the present study are useful in the treatment of POAG/OHT, but timolol is a better choice than other two drugs because of greater reduction in IOP and greater cost-effectiveness.
ABSTRACT
Introduction: Hypertension is a multi-factorial and complex disease that has both environmental and genetic determinants. It is the single most significant risk factor for heart diseases and kidney diseases. Hypertension is a leading contributor to global burden of morbidity and mortality. It is considered as a silent killer because most of the time it is asymptomatic and goes undetected. Hence, hypertensive patients should be prescribed properly. Objectives: To evaluate the prescribing pattern of anti-hypertensive drugs in patients of hypertension. Material and Methods: This was an observational, cross sectional study conducted over a period of 1 year on hypertensive patients attending the Cardiology out-patient department of Government Medical College and Rajindra Hospital, Patiala and fulfilling the inclusion and exclusion criteria. The prescriptions were evaluated. Results: 22% of prescriptions had monotherapy, amongst which beta-blockers were most commonly prescribed. Majority of prescriptions had two drug therapy (47%), among which ARB+ beta blockers (17%) were most frequently prescribed. Beta blockers +CCB (9%) was the most common Fixed Drug Combination (FDC) prescribed. ARB+beta blockers+diuretics (14%) and ACEI+ARB+beta blockers+diuretics (1%) were most commonly prescribed three drug combinations. Among four drug combinations, only ACEI+ARB+beta blockers+diuretics was prescribed to 1% patients. Hypolipidemic drugs (66%) were maximally co-prescribed. Conclusions: A high trend of polypharmacy was observed in hypertensive patients. So, emphasis is needed to reevaluate the prescribing trends in these patients.
ABSTRACT
Introduction: Osteoarthritis is the most common form of arthritis. Osteoarthritis is a joint failure, which occurs due to pathological change in all structure joint. Aim: The aim of the study was to compare the efficacy and tolerability of Rosehip Extract and ibuprofen along with individual effect of both drugs. Materials and Methods: This was an open, randomized, prospective study to compare ROSE HIP Extract and IBUPROFEN for treatment of Osteoarthritis in 100 patients. In this study two comparative groups (50 each) were taken. First group was prescribed 400 mg TDS Ibuprofen and the other group was given Rose hip extract in the form of 275 mg capsule BD. The pain assessment was done through Womac scale and visual analogue scale. The data was collected for efficacy and tolerability for both drugs at 14 days and 3 months. Result: In ibuprofen group, the mean score of pain intensity on womac scale on visit 1 was 39.2 ± 9.58 which was decreased to 11.62 ± 4.97 in the last visit. On VAS scale on visit 1 was 7.26 ± 1.426 and was decreased to 3.36 ± 1.467 at visit 3. In rosehip group. The mean score of pain intensity on WOMAC scale on visit 1 was 38.44 ± 8.45, 30.88 ± 8.068 which was decreased to 26.68 ± 8.474. The mean score of pain intensity at on VAS scale on visit 1 was 7.02 ± 1.06, 5.84 ± 1 and was decreased to 4.6 ± 1.16 at the end of study. Conclusion: Ibuprofen is a better choice than rosehip because it had shown better improvement. Both rosehip and ibuprofen were well tolerated.
ABSTRACT
Background: Hypertension(HTN) is a major cardiovascular disease and is a major worldwide clinical problem. The prevalence of hypertension increases in urban and rural areas. The treatment of hypertension began in the 1960s with oral diuretics. The other modalities of treatment of hypertension are beta – blockers, calcium-channel blockers, alphareceptors blockers, ACE inhibitors and ARBs. The better compliance occurs with single-pill combination, and may be even double or even triple pill combination therapy should be used. Also quality of life was improved better with Metoprolol and Telmisartan as compared with Metoprolol and Ramipril. Quality of life was assessed by SF -36 Quiestionnare. Objective: To compare the effect of Metoprolol and Telmisartan versus Metoprolol and Ramipril on BP and quality of life in patients of hypertension. Material and Methods: In this prospective, open, randomized, parallel group, comparative study, 80 patients of hypertension attending the Cardiology Outpatient Department, Govt. Medical College & Rajindra Hospital, Patiala were recruited. This randomized comparative study was done on 80 patients for 4 months. Quality of Life: In my project of Quality of life, I had taken total 80 patients and the patients were divided into two groups and 40 patients each of Metoprolol and Ramipril versus Metoprolol and Telmisartan. To assess quality of life questionnaire SF-36 was administered to the patients. Results: There was a marked decrease in SBP and DBP with the use of Metoprolol and Telmisartan than Metoprolol and Ramipril. There was also no change in demographic parameters. There was significant improvement in the quality of life with Metoprolol and Telmisartan. Conclusion: Metoprolol and Telmisartan was a better choice than Metoprolol and Ramipril in treating hypertension as this combination causes more reduction in BP and little effect on HR.
ABSTRACT
Background: The multidrug resistant among uropathogenic E. coli has become a potential threat to global health. The aim of the current study to evaluate the antimicrobial activities of nitrofurantoin and fosfomycin along with other antimicrobials against Extended Spectrum β-Lactamases (ESBL) and AmpC producer isolates from the most common organism E. coli. Methods: A total of 6046 clean catch midstream urine samples were collected and processed in Microbiology department of tertiary care hospital. The antimicrobial susceptibility of E. coli isolates was initially screened by Kirby-Bauer disk diffusion method. The resistant isolates were confirmed to be ESBL and AmpC producers by their respective phenotypic confirmatory tests of combined disc method. Results: Out of 6046 patients there were 1855 E. coli positive patients. Maximum patients in the age group of 21-30 years were 51.5% followed by 31-40 years where patients were 26%. 64.4% E. coli were isolated from female patients and 35.6% from male patients. E. coli showed higher sensitivity towards, fosfomycin (100%), imipenem (100%), nitrofurantoin (84.1%), piperacillin and tazobactam (77.3%), amikacin (76.1%) and while they showed high degree resistance pattern against Penicillin, cotrimoxazole, ciprofloxacin, norfloxacin and 2nd and 3rd generation cephalosporin. Out of 1855 E. coli, multi drug resistance was seen in 520 E. coli isolates. ESBL production was observed among 50% of E. coli isolates by combined disk method. Out of 520 isolates, 150 isolates showed resistance to one or more extended-spectrum cephalosporins and cefoxitin by Kirby-Bauer disk diffusion method. These were selected and screened for ESBL and AmpC production. Among 150 cefoxitin-resistant isolates, AmpC phenotype was detected in 100 isolates (66.6%) by AmpC disc method. The overall occurrence of AmpC in the study was found to be 19.2%. Susceptibility of ESBL and AmpC producers to fosfomycin, imipenem, nitrofurantoin and amikacin were found to be 100%, 98.5%, 89% and 75% respectively. Conclusions: There is increased prevalence of ESBL and AmpC producing E. coli. Thus, early detection of ESBL and AmpC producer E. coli by simple phenotypic methods is necessary to avoid treatment failure, where molecular techniques are not available.
ABSTRACT
Introduction: Diabetes mellitus frequently leads to development of peripheral neuropathies in almost 30-50% of patients and the most common type of neuropathy associated with this condition is Distal Symmetric Sensorimotor Polyneuropathy (DSPN). Gabapentin and Amitriptyline are two drugs frequently used for the treatment of neuropathic pain associated with type 2 diabetes. Aim of the study: The aim of this study was to compare efficacy and safety of Gabapentin and Amitriptyline in subjects of Type 2 diabetes mellitus with peripheral neuropathic pain. Material and Methods: A prospective, open, randomized, parallel group, comparative study was conducted in 60 patients coming to Department of Medicine, Rajindra Hospital attached to Government Medical College Patiala, to evaluate the efficacy and safety of Gabapentin and Amitriptyline in patients with diabetic peripheral neuropathic pain. The patients fulfilling the inclusion criteria were included in the study after taking written informed consent. The patients were divided into two groups of 30 cases each by simple randomization. Group I patients received Gabapentin 300 mg HS by oral route. Group II patients received Amitriptyline 25 mg HS by oral route. Therapeutic efficacy of both drugs, by using Michigan Neuropathy Screening Instrument (MNSI) was compared at the baseline and at the end of 4 months. Any adverse drug reactions of the respective drug observed in patient were also noted. All the observations thus made were statistically analysed using appropriate tests. Results: Baseline characteristics of the patients in two groups such as age, sex, duration of diabetes were similar (p>0.05). The mean age in group I and group II were 53.40±8.41 years and 57.17±8.55 years, respectively. There was statistically significant reduction in mean MNSI scores in questionnaire part and physical examination part in both the groups. Also, there was statistically significant difference between the two drugs in reducing mean MNSI score. Mean difference between two drugs in reducing MNSI score in history part (0.77±0.16, p<0.01) and physical examination part (0.75±0.19, p<0.01) favoured Gabapentin. No. of adverse drug reactions reported were significantly higher in Amitriptyline group, p value (<0.05) for the difference in ADRs between two drugs was statistically significant. Conclusion: In this study, we concluded that both drugs lead to improvement in signs and symptoms of diabetic neuropathy. Gabapentin was proved to be more efficacious than Amitriptyline. Gabapentin treated patient’s mean MNSI score at the study end point was significantly lower as compared to the Amitriptyline treated patient’s end-point score. Adverse drug reactions reported in our study were mild in both the groups and a significantly higher number of adverse effects were reported in the amitriptyline group. Dizziness and somnolence were two most commonly reported adverse drug reactions.
ABSTRACT
Aim: A pharmacoeconomic analysis to determine the relative cost-effectiveness of timolol 0.5%, brinzolamide 1% and brimonidine 0.2% eye drops in treatment of Primary Open Angle Glaucoma (POAG)/ocular hypertension (OHT). Settings and Design: Comparative, open, randomized, parallel group prospective study. Materials and Methods: 60 patients of POAG or ocular hypertension were included in this study. Time period of study was 6 weeks. 60 eyes of 60 patients were included in the study. Patients were divided randomly into 3 groups of 20 each. Patients in group A, B and C received timolol, brinzolamide and brimonidine respectively. One drop of each medication was instilled twice a day at 9 am and 9 pm daily for 6 weeks. IOP was measured on day 0 at 9 am (before administration of drugs) and then at 11 am, to get baseline IOP. IOP was again measured on subsequent visits at 9 am and 11 am. Treatment outcome was number of mm Hg fall in IOP induced by the study drug. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost‑effectiveness was then calculated as the cost of drug/mm Hg fall in IOP. Statistics: Paired ‘t’ test was used to analyze the parameters within the group. Independent samples t‑test was used to compare the efficacy of drugs with each other. Results: The % reduction of brimonidine, timolol and brinzolamide at end of 6 weeks was 21.43 ± 3.06%, 24.87 ± 2.46% and 18.78 ± 1.73% respectively. Timolol was superior in efficacy to other two drugs. The difference was statistically significant between the efficacy of timolol and brinzolamide (p < 0.001) as well as timolol and brimonidine (p = 0.003). There was no statistical significant difference in the efficacy of brimonidine when compared to brinzolamide (p=0.26). Timolol (5.87 ± 0.83 Rs/mm lowering after 6 weeks) was found to be most cost-effective followed by brimonidine (46.83 ± 7.37) and then brinzolamide (60.49 ± 6.77) in lowering IOP. Conclusion: All three drugs under the present study are useful in the treatment of POAG/OHT, but timolol is a better choice than other two drugs because of greater reduction in IOP and greater cost-effectiveness.
ABSTRACT
Introduction: Hypertension is a multi-factorial and complex disease that has both environmental and genetic determinants. It is the single most significant risk factor for heart diseases and kidney diseases. Hypertension is a leading contributor to global burden of morbidity and mortality. It is considered as a silent killer because most of the time it is asymptomatic and goes undetected. Hence, hypertensive patients should be prescribed properly. Objectives: To evaluate the prescribing pattern of anti-hypertensive drugs in patients of hypertension. Material and Methods: This was an observational, cross sectional study conducted over a period of 1 year on hypertensive patients attending the Cardiology out-patient department of Government Medical College and Rajindra Hospital, Patiala and fulfilling the inclusion and exclusion criteria. The prescriptions were evaluated. Results: 22% of prescriptions had monotherapy, amongst which beta-blockers were most commonly prescribed. Majority of prescriptions had two drug therapy (47%), among which ARB+ beta blockers (17%) were most frequently prescribed. Beta blockers +CCB (9%) was the most common Fixed Drug Combination (FDC) prescribed. ARB+beta blockers+diuretics (14%) and ACEI+ARB+beta blockers+diuretics (1%) were most commonly prescribed three drug combinations. Among four drug combinations, only ACEI+ARB+beta blockers+diuretics was prescribed to 1% patients. Hypolipidemic drugs (66%) were maximally co-prescribed. Conclusions: A high trend of polypharmacy was observed in hypertensive patients. So, emphasis is needed to reevaluate the prescribing trends in these patients.
ABSTRACT
Introduction: Osteoarthritis is the most common form of arthritis. Osteoarthritis is a joint failure, which occurs due to pathological change in all structure joint. Aim: The aim of the study was to compare the efficacy and tolerability of Rosehip Extract and ibuprofen along with individual effect of both drugs. Materials and Methods: This was an open, randomized, prospective study to compare ROSE HIP Extract and IBUPROFEN for treatment of Osteoarthritis in 100 patients. In this study two comparative groups (50 each) were taken. First group was prescribed 400 mg TDS Ibuprofen and the other group was given Rose hip extract in the form of 275 mg capsule BD. The pain assessment was done through Womac scale and visual analogue scale. The data was collected for efficacy and tolerability for both drugs at 14 days and 3 months. Result: In ibuprofen group, the mean score of pain intensity on womac scale on visit 1 was 39.2 ± 9.58 which was decreased to 11.62 ± 4.97 in the last visit. On VAS scale on visit 1 was 7.26 ± 1.426 and was decreased to 3.36 ± 1.467 at visit 3. In rosehip group. The mean score of pain intensity on WOMAC scale on visit 1 was 38.44 ± 8.45, 30.88 ± 8.068 which was decreased to 26.68 ± 8.474. The mean score of pain intensity at on VAS scale on visit 1 was 7.02 ± 1.06, 5.84 ± 1 and was decreased to 4.6 ± 1.16 at the end of study. Conclusion: Ibuprofen is a better choice than rosehip because it had shown better improvement. Both rosehip and ibuprofen were well tolerated.
ABSTRACT
Background: Hypertension(HTN) is a major cardiovascular disease and is a major worldwide clinical problem. The prevalence of hypertension increases in urban and rural areas. The treatment of hypertension began in the 1960s with oral diuretics. The other modalities of treatment of hypertension are beta – blockers, calcium-channel blockers, alphareceptors blockers, ACE inhibitors and ARBs. The better compliance occurs with single-pill combination, and may be even double or even triple pill combination therapy should be used. Also quality of life was improved better with Metoprolol and Telmisartan as compared with Metoprolol and Ramipril. Quality of life was assessed by SF -36 Quiestionnare. Objective: To compare the effect of Metoprolol and Telmisartan versus Metoprolol and Ramipril on BP and quality of life in patients of hypertension. Material and Methods: In this prospective, open, randomized, parallel group, comparative study, 80 patients of hypertension attending the Cardiology Outpatient Department, Govt. Medical College & Rajindra Hospital, Patiala were recruited. This randomized comparative study was done on 80 patients for 4 months. Quality of Life: In my project of Quality of life, I had taken total 80 patients and the patients were divided into two groups and 40 patients each of Metoprolol and Ramipril versus Metoprolol and Telmisartan. To assess quality of life questionnaire SF-36 was administered to the patients. Results: There was a marked decrease in SBP and DBP with the use of Metoprolol and Telmisartan than Metoprolol and Ramipril. There was also no change in demographic parameters. There was significant improvement in the quality of life with Metoprolol and Telmisartan. Conclusion: Metoprolol and Telmisartan was a better choice than Metoprolol and Ramipril in treating hypertension as this combination causes more reduction in BP and little effect on HR.
ABSTRACT
Background: The multidrug resistant among uropathogenic E. coli has become a potential threat to global health. The aim of the current study to evaluate the antimicrobial activities of nitrofurantoin and fosfomycin along with other antimicrobials against Extended Spectrum β-Lactamases (ESBL) and AmpC producer isolates from the most common organism E. coli. Methods: A total of 6046 clean catch midstream urine samples were collected and processed in Microbiology department of tertiary care hospital. The antimicrobial susceptibility of E. coli isolates was initially screened by Kirby-Bauer disk diffusion method. The resistant isolates were confirmed to be ESBL and AmpC producers by their respective phenotypic confirmatory tests of combined disc method. Results: Out of 6046 patients there were 1855 E. coli positive patients. Maximum patients in the age group of 21-30 years were 51.5% followed by 31-40 years where patients were 26%. 64.4% E. coli were isolated from female patients and 35.6% from male patients. E. coli showed higher sensitivity towards, fosfomycin (100%), imipenem (100%), nitrofurantoin (84.1%), piperacillin and tazobactam (77.3%), amikacin (76.1%) and while they showed high degree resistance pattern against Penicillin, cotrimoxazole, ciprofloxacin, norfloxacin and 2nd and 3rd generation cephalosporin. Out of 1855 E. coli, multi drug resistance was seen in 520 E. coli isolates. ESBL production was observed among 50% of E. coli isolates by combined disk method. Out of 520 isolates, 150 isolates showed resistance to one or more extended-spectrum cephalosporins and cefoxitin by Kirby-Bauer disk diffusion method. These were selected and screened for ESBL and AmpC production. Among 150 cefoxitin-resistant isolates, AmpC phenotype was detected in 100 isolates (66.6%) by AmpC disc method. The overall occurrence of AmpC in the study was found to be 19.2%. Susceptibility of ESBL and AmpC producers to fosfomycin, imipenem, nitrofurantoin and amikacin were found to be 100%, 98.5%, 89% and 75% respectively. Conclusions: There is increased prevalence of ESBL and AmpC producing E. coli. Thus, early detection of ESBL and AmpC producer E. coli by simple phenotypic methods is necessary to avoid treatment failure, where molecular techniques are not available.
ABSTRACT
Although many agents have therapeutic potentials for Central Nervous System (CNS) diseases, few of these agents have been clinically used because of the brain barriers. Physiological barriers like the blood-brain barrier and blood-cerebrospinal fluid barrier as well as various efflux transporter proteins make the entry of drugs into the central nervous system very difficult. Different strategies for efficient CNS delivery have been studied. This review presents the current approaches to facilitate penetration across these barriers for enhanced drug delivery to the CNS.
ABSTRACT
Although many agents have therapeutic potentials for Central Nervous System (CNS) diseases, few of these agents have been clinically used because of the brain barriers. Physiological barriers like the blood-brain barrier and blood-cerebrospinal fluid barrier as well as various efflux transporter proteins make the entry of drugs into the central nervous system very difficult. Different strategies for efficient CNS delivery have been studied. This review presents the current approaches to facilitate penetration across these barriers for enhanced drug delivery to the CNS.
ABSTRACT
Background: Drug prescription in menopause is complex as estrogen deficiency, hypertension (HT) and other risk factors, rapidly increase the risk of cardiovascular diseases (CVD) in post-menopausal women (PMW). Objectives: To evaluate the prescription trends of anti-hypertensive drugs in PMW. Methods: This was an observational, cross sectional study conducted over a period of 1 year, on hypertensive PMW. The prescriptions were evaluated for antihypertensive drug use patterns and also as per WHO core drug indicators. Results: 21.82% of prescriptions had monotherapy, amongst which angiotensin receptor blockers (ARB) (10%) and individually, telmisartan (5.45%) were most commonly prescribed. Majority of prescriptions had two drug therapy (44.09%), among which ARB + beta-blockers (BB) (20.91%) and individually, Telmisartan + Metoprolol (13.64%) were most frequently prescribed. ARB + Diuretic (DI) (9.55%) was the most common fixed drug combination (FDC) prescribed. ARB + BB + DI (10.45%), ARB + 2DI + BB (4.09%) and ARB + 2DI + BB + Calcium channel blocker (1.82%) were most commonly prescribed three, four and ≥five drug combinations, respectively. Hypolipidemic drugs (60.45%) were maximally co-prescribed. Percentage of drugs prescribed by generic name was 4.63% and from essential drug list was 32.62%. Conclusions: A high trend of polypharmacy was observed in hypertensive PMW. HT, being a multifactorial disease, deserves a multidisciplinary and a comprehensive approach in the care of this population subgroup. Knowledge of prescription pattern and thus the rational utilisation of drugs will help achieve better control rates of HT and hence curb down the burden of CVDs in PMW.
ABSTRACT
Background: Drug prescription in menopause is complex as estrogen deficiency, hypertension (HT) and other risk factors, rapidly increase the risk of cardiovascular diseases (CVD) in post-menopausal women (PMW). Objectives: To evaluate the prescription trends of anti-hypertensive drugs in PMW. Methods: This was an observational, cross sectional study conducted over a period of 1 year, on hypertensive PMW. The prescriptions were evaluated for antihypertensive drug use patterns and also as per WHO core drug indicators. Results: 21.82% of prescriptions had monotherapy, amongst which angiotensin receptor blockers (ARB) (10%) and individually, telmisartan (5.45%) were most commonly prescribed. Majority of prescriptions had two drug therapy (44.09%), among which ARB + beta-blockers (BB) (20.91%) and individually, Telmisartan + Metoprolol (13.64%) were most frequently prescribed. ARB + Diuretic (DI) (9.55%) was the most common fixed drug combination (FDC) prescribed. ARB + BB + DI (10.45%), ARB + 2DI + BB (4.09%) and ARB + 2DI + BB + Calcium channel blocker (1.82%) were most commonly prescribed three, four and ≥five drug combinations, respectively. Hypolipidemic drugs (60.45%) were maximally co-prescribed. Percentage of drugs prescribed by generic name was 4.63% and from essential drug list was 32.62%. Conclusions: A high trend of polypharmacy was observed in hypertensive PMW. HT, being a multifactorial disease, deserves a multidisciplinary and a comprehensive approach in the care of this population subgroup. Knowledge of prescription pattern and thus the rational utilisation of drugs will help achieve better control rates of HT and hence curb down the burden of CVDs in PMW.
ABSTRACT
The World Health Organisation estimates that one-third of the world's population are currently infected with Tuberculosis bacillus, 10% of whom will develop the disease at some point in their lifetime. Poverty-Stricken countries of Africa and Asia bear the brunt of the disease partly due to an ominous synergy between mycobacterium bacteria and HIV. The recent recognition of MDR-TB and strains with more complex resistance patterns has stimulated the development of new TB medications including fluoroquinolones, oxazolidinones, diarylquinolines, nitroimidazopyrans. Delamanid, a newer mycobacterial cell wall synthesis inhibitor, received a conditional approval from European medicines agency (EMA) for the treatment of MDR‑TB. Preclinical and clinical studies have shown that delamanid has high potency, least risk for drug‑drug interactions and better tolerability. The purpoe of this article is to bring forward, the various roles played by Delamanid in order to curb the problem of Multi-drug resistant Tuberculosis
ABSTRACT
Designing of drugs and their development are a time and resource consuming process. There is an increasing effort to introduce the role of computational approach to chemical and biological space in order to organise the design and development of drugs and their optimisation. The role of Computer Aided Drug Designing (CADD) are nowadays expressed in Nanotechnology, Molecular biology, Biochemistry etc. It is a diverse discipline where various forms of applied and basic researches are interlinked with each other. Computer aided or in Silico drug designing is required to detect hits and leads. Optimise/ alter the absorption, distribution, metabolism, excretion and toxicity profile and prevent safety issues. Some commonly used computational approaches include ligand-based drug design, structure-based drug design, and quantitative structure-activity and quantitative structure-property relationships. In today's world, due to an avid interest of regulatory agencies and, even pharmaceutical companies in advancing drug discovery and development process by computational means, it is expected that its power will grow as technology continues to evolve. The main purpose of this review article is to give a brief glimpse about the role Computer Aided Drug Design has played in modern medical science and the scope it carries in the near future, in the service of designing newer drugs along with lesser expenditure of time and money
ABSTRACT
Background: Osteoarthritis is a slowly progressive disorder associated with a hyaline cartilage loss. Non-steroidal antiinflammatory drugs play a pertinent role in management of osteoarthritis. Objectives: The study was carried out for the comparison of efficacy and tolerability of Aceclofenac and Diclofenac in patients of osteoarthritis of knee joint. Material and Methods: It is a randomised parallel group double blinded study. The study included 60 patients of confirmed osteoarthritis of knee joint, 30 patients were given Aceclofenac and 30 patients were given Diclofenac after food for 8 weeks and the patients were evaluated and compared statistically for pain intensity by VAS Score, Joint tenderness, Swelling, Erythema, Pain on movement, Functional capacity and Overall Assessment on LIKERT Scale. Results: Both the drugs caused marked improvements in the parameters of - Pain intensity, Joint tenderness, Swelling, Erythema, Pain on movement of OA knee joint but there was increased improvement in all the parameters with aceclofenac. Conclusion: Aceclofenac is the NSAID of choice in the osteoarthritis of knee joint as compare to Diclofenac.