ABSTRACT
Background: The fixed dose drug combinations (FDCs) of drugs is defined as product of two or more active ingredients in a defined composition. There is a need to study the pattern of prescription from time to time to evaluate their rationality. In this context we undertook this study to know the prescription pattern of FDC in our setting. To study the rationality of different prescribed FDCs.Methods: This is a prospective study which is carried out in NIMRA Institute of medical sciences which is a tertiary care teaching private hospital. For this study we have collected one thousand prescriptions of patients for 3 months that is from 10th March 2017 to 25th of June 2017 including both in-patients as well as outpatients. Selection criteria of patients mainly basing on their willingness to give prescriptions. Institutional ethical committee permission was taken for the study. The prescribed FDCs were compared with the essential drug list of FDCs approved by Drugs Controller General of India, July 2018. we have used descriptive statistics to analyze data. The percentage of FDCs used in each class and their contribution to overall FDCs were calculated.Results: In a total of 2952 drugs were prescribed, of this 747 were FDCs and 2205 were non FDCs. In the prescribed FDCs 89.2% drugs were rational and 10.8% drugs were irrational.Conclusions: From this study, we can conclude that 10.8% of irrational prescription of fixed dose drug combinations are prescribed in Nimra Institute of Medical Sciences which is a tertiary care teaching private hospital.
ABSTRACT
Background: Urticaria results from many different stimuli and numerous factors like immunologic, non-immunologic, genetic and modulating factors which are involved in its pathogenesis and ultimately converge on mast cells and basophils to release mediators and produce urticarial lesions. This study is aimed to compare the therapeutic effectiveness of Levocetirizine (newer generation H1 blocker), prednisolone (glucocorticoid) and their combination in the treatment of chronic urticaria.Methods: Group I (34 patients received tab Levocetirizine alone 5mg daily for 15 days). Group II (33 patients received tab Prednisolone alone 20mg /day for initial 3 days and later dose was gradually tapered by 5mg /day every 3 days to 5mg/day with total duration of 12 days). Group III (33 patients received the combination of Levocetirizine and Prednisolone).Results: The Group -I patients average eosinophil count before and after treatment was 4±1.4 and 2.4±0.8 respectively, with an average difference of 1.7±1.3. In Group - II patients average eosinophil count before and after treatment was 4.0±1.1 and 2.5±0.3 respectively, with an average difference of 1.5±1.1. In the Group - III patients the average eosinophil count before and after treatment was 4.3±1.0 and 2.1±1.0 with an average difference of 2.2±1.3. In G-I (n=34).Conclusions: Statistical analysis of the present study showed that the combination of Levocetirizine and prednisolone therapy was significantly (P<0.05) greater than prednisolone alone therapy and improvement with Levocetirizine alone (79%) was almost similar to combination therapy (85%).
ABSTRACT
Background: Benefi cial effect in reducing microalbuminuria of diabetic nephropathy with angiotensin converting enzyme (ACE) inhibitor and angiotensin II receptor blockers (ARB) is proven. This study has directly compared the renoprotective effects of ARB and ACE inhibitors in persons with type-2 diabetes. Methods: In this prospective, double-blind, controlled trial, 100 patients with type 2 diabetes mellitus were chosen and randomly assigned to either receive ACE inhibitor (ramipril 5 mg, 50 patients) or ARB (losartan 50 mg, 50 patients). The endpoint was a reduction in 24 hrs urine microalbuminuria after a period of 3 months treatment. Results: At the end of 3 months treatment, the mean reduction of 24 hrs urine microalbuminuria in the ramipril group was 25 mg as compared to 38 mg in the losartan group; (t value=1.11, p=0.27). There was no statistical difference in the mean reduction when compared between the two groups. Signifi cant reduction of blood pressure especially systolic blood pressure was noted in the losartan group as compared to those who received ramipril. Conclusion: Losartan was not inferior to ramipril in providing renoprotection in subjects with type 2 diabetes and early nephropathy. Losartan showed a signifi cant reduction in systolic blood pressure, though not much reduction was seen with ramipril. Despite this, both drugs have shown a reduction in microalbuminuria, which supports the fact that reduction in microalbuminuria is independent of the antihypertensive action of ramipril or losartan.