Evaluation of antidiabetic prescriptions from medical reimbursement applications at Banaras Hindu university health care facility

Diabetes is on rapid increase in third world countries undergoing rapid transition in terms of development particularly in India, which is often being referred as Diabetic capital. It is a disease more prevalent at latter part of life of human beings when finances dwindle and social care gets neglected. The medication continues till the whole life on a regular basis. In present study, the objective has been to provide pharmacoeconomic medication to the diabetic pensioners in the backdrop as mentioned in above background. The data was collected at the medical reimbursement section of pensioners of the University. The data was examined to answer issues of therapeutic decisions in the light of the pharmacoeconomic considerations. In this paper essentially data on choice of prescriptions with the angle of pharmacoeconomic prudence were included. The dichotomy of specialist versus non specialist prescribers at the tertiary center [i.e. medical college hospital] was compared. Effort was made to define merit of the prescription based on comprehensive considerations of patient profile, disease profile and therapeutic choice. Total 72 prescriptions were analyzed for the study in which 475 drugs were prescribed to the patients. Total antidiabetic drugs prescribed to the patients were 169. Out of 72 cases 39 were males and 33 were females with mean age 66.04 +/- 5.80 [Mean +/- SEM]. The average number of drugs per prescription was 6.59 which was very high as per guidelines. Most commonly prescribed antidiabetic drug was Metformin [63.89%] followed by Glimepiride [31.95%]. This study reflects that there is need to make available the standard therapeutic option at University Health Care Facility based upon pharmacoeconomic considerations

Effectiveness of vitiligo therapy in prospective observational study of 250 cases with review of consensus and individualized care perspective

Outcomes of six month therapy in 250 patients bearing varying disease profiles and treatment regimens delivered either in conformity or divergence from consensus guidelines were compared. Influence of trait variables of patients and disease on the outcomes was also examined. Consensus approach yielded superior rates of repigmentation and improved quality of life. The latter effect significantly influenced the former. Therapy adhering guidelines did not yield optimal benefit in patients of younger age, with disease of shorter standing and involving resistant sites. Steroids best benefited the localized disease as topical monotherapy. Combination of steroid with photochemotherapy adhering guidelines benefited less in moderate disease extent. Steroid overtreatment in extensive disease compromised the prospects of repigmentation. Localized short duration disease may better be first treated with steroid-alternative immunosuppressants. Wider spread more than 3% body surface may also respond to their combination with steroids, prior applying photochemotherapy. Additive therapies are prudent with steroid/photochemotherapy than injudicious steroid overuse in progressive extensive disease. Strategies to counter steroid unresponsiveness and adverse effects, psychiatric address to stress, nutrient and environmental interventions deserve emphasis