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Background: Chronic kidney disease can progress to end-stage kidney failure (ESRD), which is fatal without artificial filtering (dialysis) or a kidney transplant.Methods: The ESRD patients of either gender age >18 years who were diagnosed by nephrologist as ESRD and are on haemodialysis regularly included for the study.Results: The blood urea, serum creatinine, phosphorous, potassium levels were reduced significantly in post – haemodialysis condition, but, there was not much weight reduction after haemodialysis. Serum albumin, serum sodium and blood haemoglobin levels were almost unchanged in post – haemodialysis state. There was no significant difference between the pre and post haemodialysis parameters- serum Na+ serum albumin and blood hemoglobulin. Out of 75 ESRD patients, almost all patients 74 (98.7%) prescribed tablet Livogen, 73 (97.3%) patients given Inj. EPO, 55 (73.3%) tab Nicardia, 54 (76%) tab Sodamint, 43 (57.3%) capsule Alpha D3, 40 (53.3%) tab Shelcal. While between 12 (16%) to 20 (26%) patients prescribed tab Nodosis, tab Metoprolol, tab Febuget, tab Ecosprin, and tab Rantac. Only 1 (1.3%) to 9 (12%) patients received tablet Augmentin, tab Arkamine, tab Carvedilol, tab Para 500, tab Atorvas, Human mixtard, tab Calcicard, tab Minipress XL, tab Dytor, and tab Clopilet.Conclusions: The available two models of treatment, i.e., haemodialysis and poly pharmacy at hospital setup to face the challenges associated with the ESRD, and even outcome after application of both these two models of therapies did not provide optimal normal healthy life status to ESRD patients.
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Objective: The study was carried out to generate research on drug utilization pattern in paediatric patients in government headquarters hospital, Tiruppur, Tamilnadu, India using world health organization (WHO) and international network for rational use of drugs (INRUD) core indicator. Methods: The core prescribing indicators of the world health organization was used to assess the appropriate use of drugs. Index of rational drug prescribing (IRDP) developed by Zhang and Zhi was also used to find out the performance of a health care system in terms of drug utilization. Results: Out of 859 drugs in 200 cases the highest prescribed drug class is antibiotics 304(35.39%) and the majority of drugs were administered in injectable form 412(47.94%). It was analysed that a majority of prescriptions 117(58.5%) were discharged in between 4-7 d. 161(80.5%) patients were dismissed after completion of treatment. On analysing world health organization (WHO) prescribing core indicators, the average number of drugs per prescription was 4.29 which is higher than double the average number (i.e., 2). This indicates poly-pharmacy practice. 97.78% of drugs were prescribed were the generic name and percentage of encounters with antibiotic prescribed was 90.5% which is thrice greater than world health organization (WHO) standard<30%. Prescribing of injections is not within the world health organization (WHO) recommended range<20% and it was far higher showing 97.5% which is essential for paediatric inpatients. The prescribing practice in paediatric ward is in complete adherence to national essential drug list (EDL) or formulary. The mean value of the index of rational drug prescribing (IRDP) obtained was 3.09 which is very similar to that of optimal value world health organization (WHO). Conclusion: Prescription by generic name, prescribing drugs from essential drug list (EDL) and free government supply are encouraging findings in this hospital. The result shows poly-pharmacy and overuse of antibiotics are the areas to be concerned. The better clinical outcome shows rational prescribing is practised well.
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Background: Irrational prescribing of drugs is of common occurrence in clinical practice. Rational drug prescribing is defined as “the use of the least number of drugs to obtain the best possible effects in the shortest period and at a reasonable cost”. The present study was designed to evaluate the practice of rational prescription in patients (cases) admitted in various wards of G.S.V.M. Medical College and associated hospitals at Kanpur. Methods: This study was carried out on patients admitted in different wards. For the study of drug prescribing patterns, each prescribed drug was counted only once for a patient, irrespective of change in dose and route of administration. WHO guidelines were taken into consideration. Both distribution of type of drug as well as drug category were evaluated in different departments thereafter. The characteristics chosen on each prescription provided the incidence of poly pharmacy and frequencies of prescribing of individual drug were analyzed. The data obtained were subsequently categorized systematically and analyzed by taking WHO guidelines into consideration. Results: The most commonly prescribed drugs were vitamins and tonics (57.5%) followed by anti-microbial agents (12.7%), non-steroidal anti-inflammatory drugs (10.5%), anti-hypertensive (5.2%), anti cough remedies and acid peptic disease drugs. Generic drug prescription was very low as most of drugs prescribed were proprietary. A low number of Fixed Dose Combinations (FDCs) were prescribed, this finding was in accordance with the WHO recommended list of FDCs. Items on the WHO model list of essential drugs were prescribed frequently. The use of drugs has been found to be in accordance with the disease, the patient had. Conclusions: Present study highlighted that there was a high incidence of irrational prescribing practice that increased with the total number of drugs per prescription.
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Objectives: To assess polypharmacy and patient’s knowledge regarding antihypertensives in Gynaecology and obstetrics department. Materials and Methods: This is a prospective comparative study carried out in Gynecology and Obstetrics department in two tertiary care hospitals. A interaction was done with consultants, post graduate students patients and patient’s attendants and the readings were taken. Results: A total of 200 prescription were studied and the average number of per prescription was 2.47%, poly pharmacy in 122/200, adequate knowledge was in 139/200 patients. Conclusion: The incidence of poly Pharmacy was more in our set of studies, patients compliance/adequate knowledge was good only among educated patients. The concerned health care can be improved by prescribing rational and required prescription and by motivating patients and patient’s attender, regarding the intake of drugs.