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Objective: Pemphigus Vulgaris [PV] is a chronic autoimmune disease. Corticosteroids and Immunosuppressants are the main line of treatment. The aim of this study was to evaluate the prescription pattern and patient adherence behavior with therapy. We determined the association between patient adherence and quality of life in patients with pemphigus vulgaris.Methods: A prospective observational study was conducted from February 2020 to May 2021. The age and sex of patients who were diagnosed with PV within 1 mo period and confirmative histopathological findings in Biopsy were included in the study. A total of 35 patients were analyzed and patients were reviewed for medication adherence and quality of life by using MMAS-8 and WHOQOL respectively, monthly till 3 mo after initiation of therapy. Statistical analysis was done by using Epi Info version 7.1.5.Results: Out of 140 prescriptions, vitamin C and zinc were the most common drug prescribed in 129 prescriptions followed by prednisolone prescribed in 128 prescriptions. The average number of drugs per encounter was 8.67. 97.56 % of drugs were prescribed by generic names. No significant improvement was seen in the adherence behavior of patients from 1st follow-up to 3rd follow-up. It was observed that physical, psychological, and environmental domains have significant associations with medication adherence in all 3 follow-up visits.Conclusion: It was concluded that Polypharmacy and inappropriate use of medicines may decrease the adherence behavior of patients to the therapy. Low adherence to pharmacotherapy affects the quality of life in PV patients. This study is beneficial for raising awareness about treatment adherence and also encouraging the development of appropriate interventions.
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Background: Acne vulgaris is a dermatological disorder characterised by formation of comedones and inflammatory lesions. Acne is one of the most common reason for visiting a dermatologist in early adulthood. The current line of management for mild to moderate acne is topical medications with antimicrobials and retinoids. The present study assessed the effectiveness and safety of topical combination therapy for mild to moderate acne vulgaris.Methods: An observational, prospective and comparative study conducted on newly diagnosed acne vulgaris patients who were treated with topical combination therapy. Changes in the total, inflammatory and non-inflammatory lesion counts, investigator global assessment (IGA) and dermatology life quality index (DLQI) scales were recorded to check effectiveness. Treatment emergent adverse events were recorded in suspected ADR reporting form for safety assessment.Results: Participants (n=97) were treated with three topical combination treatments either clindamycin-benzoyl peroxide (group-A), clindamycin-adapalene (group-B) or benzoyl peroxide-adapalene (group C). Majority of participants (42.3%) were treated with clindamycin-benzoyl peroxide group. Reduction from baseline of total, inflammatory and non-inflammatory lesion counts were highly significant within group comparison (p<0.001), but between group differences were not significant. Significant improvement in DLQI and IGA scores were noted in all three groups, but between group comparison showed no significant differences. All three groups were safe and well tolerated and equally improve participant’s quality of life.Conclusions: all three topical combination drugs for mild acne vulgaris had similar effectiveness in terms of reduction in acne lesions with similar safety profile.
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Background& Objective: Use of generic medicines has been increasing in recent years as a cost saving measure in health care provision. But, there is an uncertainty about whether the quality of a generic medicine is equal to, greater than or less than its equivalent brand-name drug. Its quality must be evaluated in vitro and in vivo in order to confirm their suitability for therapeutic use. Here, we have done in vitro comparison of generic and brand formulation of ceftazidime against pseudomonas standard strain (ATCC 27853). Methodology: One generic and three brands of ceftazidime were selected for in vitro comparison. Microbiological assays were used to establish the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) against pseudomonas standard strain (ATCC 27853) according CLSI (Clinical Laboratory Standard Institutes) guidelines. Results: The MIC values of the ceftazidime samples evaluated (Brand and generics) were the same for pseudomonas standard strain tested, indicating that all products behaved similarly. The MBC values were very similar for all samples. Overall, therefore, the results showed no significant differences among samples. Conclusion: Reference method MIC and MBC testing of ceftazidime against pseudomonas has demonstrated no significant difference in in vitro activity between generic and brand products.
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Background: Spontaneous reporting is an important tool in pharmacovigilance. However, its success depends on cooperative and motivated prescribers. In order to improve the reporting rate, it is essential to improve the Knowledge, Attitude and the Practices (KAP) of the healthcare professionals with regards to the ADR reporting and the pharmacovigilance. The present study was undertaken to evaluate the knowledge, attitude, and practices (KAP) of pharmacovigilance among private prescribers of Rajkot city. Methods: It was a prospective questionnaire based survey type of study which was carried out among the private practitioners of Rajkot city. A questionnaire which was suitable for assessing the basic Knowledge, Attitude and the Practice (KAP) of pharmacovigilance was designed and distributed among the private doctors and filled up forms collected back and analyzed by microsoft excel 2007. Results: Out of 600 distributed forms 332 forms were received back, reflecting a response rate of 55.33%. 13.86% doctors didn’t know about the term pharmacovigilance. 76.80% doctors experienced ADR during their clinical practices. 17.77% doctors maintain the record for patient safety and medico legal aspect.13.25% doctors reported ADR at different places. Lack of knowledge and awareness and medico legal problems were common reasons for under reporting of ADR.78.30% doctors agreed to keep ADR monitoring mandatory. Preferred methods for reporting ADR were electronic media and personal communication. Conclusions: There was a great need to create awareness among the private doctors to improve the reporting of ADRs. Even though ADR reporting make compulsory by doctors unless there is no strict government rules and regulation success of pharmacovigilance programme is questionable.
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Topiramate is an anti-epileptic drug commonly used for the treatment of abdominal migraine. Rare cases of acute myopia with secondary angle closure glaucoma have been reported due to topiramate therapy. An adult male was prescribed topiramate oral therapy for abdominal migraine. On the 4th day of treatment, he had blurring of vision and on ocular examination there was severe myopia, both the iridocorneal angles were closed and intraocular pressure (i.o.p) was 48mmHg. Diagnosis of drug induced bilateral acute angle closure glaucoma was made and treatment was started. Similar cases with topiramate were reported previously but it developed after 2 weeks of therapy. In our case it occurs on the 4th day of therapy. So physician should be aware of possible ocular side effects from the 1st day of therapy and to seek immediate ophthalmic investigation in the events.
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Background & objectives: In patients with type 2 diabetes mellitus, all therapeutic options should be evaluated for their effect on cardiovascular risk factors, in addition to glycemic control. Randomized controlled trials of pioglitazone and rosiglitazone in patients with type 2 diabetes to evaluate their effect on either glycemic control or serum lipid profile individually have been reviewed and analyzed but analysis of reports of effect on both these parameters simultaneously are very few and such meta-analysis has not been carried out earlier. This article presents meta-analysis of randomized controlled trials of pioglitazone and rosiglitazone in patients with type 2 diabetes to evaluate their effect on glycemic control as well as serum lipid profile. Methods: We identified the citations by searching the web site of MD-consult, National Library of Medicine and Google for identifying randomized controlled trails pertinent to the thiazolidinediones of interest (rosiglitazone and pioglitazone) and evaluated then compared effect of these two drugs on glycemic control and serum lipid profile by applying student’s t-test.Results: Twelve randomized controlled trials (n=10052) were identified. Both thiazolidinediones produced significant reduction in HbA1c and FPG. Pioglitazone significantly reduced TG and increased HDL-C levels without significant effect on LDL-C and Total CH; while rosiglitazone significantly increased HDL-C, LDL-C, Total CH and slightly increased TG. Comparatively, they did not differ in their effect on glycemic control but regarding lipid profile, pioglitazone significantly reduced TG whereas rosiglitazone slightly increased TG level. Rosiglitazone produced significantly more increase in LDL-C and total CH level as compared to pioglitazone. Interpretation & conclusion: Pioglitazone had significantly more beneficial effects on lipid profile than Rosiglitazones and is clinically superior in patient of Type-2 DM with dyslipidemia.