Patient’s adherence to antihypertensive drugs in a tertiary care hospital: A cross-sectional study

Background: Hypertension (HTN) is a serious public health problem. Good control of the disease has always been considered to be essential for reducing its morbidity and mortality. Poor adherence to treatment is the single most important reason for uncontrolled blood pressure, serious complications, and wastage of health-care resources. Aims and Objectives: This study aims to assess the antihypertensive medication adherence level among hypertensive study participants, and identify and evaluate the barriers to antihypertensive medication adherence. Materials and Methods: A hospital-based descriptive cross-sectional study was conducted in tertiary care medical college hospital in Madurai, Tamil Nadu, involving 332 patients and the collected data were presented as means (standard deviations) and percentages. Comparison of data was performed using Pearson’s Chi-square test. For all statistical analyses, commercially available computer program was used. Results: Among 332 study participants having age range of 31–78 years with a mean age of 57.49 ± 9.20 years, female (approx. 60%) were more than male (40%) participants. About 96.7% of respondents were aware that HTN could cause severe consequences with regard to their health and daily activity but more than half were taking medium salt (56.0%) and more than one-third (32.8%) were taking fatty rich diet. Only one-fourth (25.6%) had good medication adherence. Male participants (34.8%) were more adherent to medication than female (20.2%) and this was statistically significant with P = 0.003. Conclusion: Around 3/4th of study participants (72.9%) were poorly adherent to antihypertensive medication. Hence, there should be improvement in awareness for both the patients and the care providers.

A novel approach for drug discovery-drug repurposing

Drug repurposing refers to finding a new indication for a pre-existing drug. It is a novel way of drug discovery that greatly reduces the time and money spent in the drug discovery process. This approach is associated with a better chance of successful drug approval. Both previously approved drugs as well as drugs that have failed in the trials conducted for their original indication can be repurposed. Even drugs withdrawn from market for their original indication can be repurposed for a new indication. Starting with Sildenafil which is the oldest example of repurposed drug to the recently repurposed drug tocilizumab for COVID-19, the list of repurposed drugs is a big one. The regulatory pathway to be followed for a repurposed drug is different from that for a new chemical entity. Furthermore, the period of marketing exclusivity for repurposed drug is only 3 years as against the 20 years of patent protection period for new drug. The strategy for drug repurposing may be a serendipitous one or hypothesis driven one. The hypothesis driven strategy includes the experimental and computational approaches. Computational approaches for drug discovery, especially the Connectivity map approach, offer a lot of scope to understand the drug-disease-gene link, thereby acting as a kick-starter for drug repurposing. Drug repurposing has real potential to offer a cure for rare genetic conditions and cancers. This review covers the various drug repurposing approaches in detail, the regulatory pathway for repurposed drugs, salient examples of repurposed drugs and also the challenges associated with drug repurposing.

Seasonal variation of arsenic concentrations in tubewells in west Bengal, India.

This study was conducted to monitor the changes in arsenic concentration during different seasons in a one-year period during 2002-2003 in selected tubewells in an arsenic-affected area in the district of South 24 Parganas in West Bengal, India, and to map the location of the wells. Seasonal variations in concentrations of arsenic in water were measured from 74 selected tubewells, ranging in depth from 40 to 500 feet. Water samples were collected from these wells during winter, summer, monsoon, and the following winter in 2002-2003. A global positioning system was used for locating the tubewells, and a geographic information system was used for mapping. There was evidence of seasonal variation in concentrations of arsenic in water (p=0.02) with the minimum average concentration occurring in the summer season (694 microg/L) and the maximum in the monsoon season (906 microg/L). From the winter of 2002 to the winter of 2003, arsenic concentrations increased, irrespective of the depth of the tubewells, from an average of 464 microg/L to 820 microg/L (p<0.001). This extent of variation in arsenic concentration, if confirmed, has important implications for both epidemiological research and mitigation programmes.