Drug utilization study in ophthalmology outpatient department of a tertiary care teaching hospital

Background: Drug utilization studies (DUS) provide insight into recent trend of drug usage and facilitate rationality of prescribed drugs. Few DUS have been conducted in ophthalmology. Aim and Objective: To analyse the prescription pattern in outpatients of the ophthalmology department at a tertiary care teaching hospital. Materials and Methods: A prospective, observational and cross-sectional study was conducted at GCS Medical College Hospital and Research Centre, Ahmedabad. All patients who visited ophthalmic outpatient department were enrolled and necessary data were recorded regarding drugs prescribed in pre-defined case record form. Data analysis was carried out using Microsoft Excel. Results: A total of 388 prescriptions were analysed. Average number of drugs and fixed-dose combinations (FDCs) per prescription were 2.47 (95% CI, 2.29–2.64) and 0.44 (95% CI, 0.36–0.51), respectively. Drugs were prescribed in different dosage forms with eye drops being the most common (95.1%) followed by tablet (12.3%), ointments (8.5%), capsules (2.8%), syrup (1.1%), and injections (0.3%). One or more dosage forms were seen per prescription. Total 957 drugs were prescribed, out of which drugs with brands name and generic name were 88.4% and 11.6%, respectively. Total FDCs prescribed were 17.5%. Overall, 43.5% of prescriptions had antibiotics ranging from 1 to 5 per prescription and 25% of antibiotics were seen out of total drugs. Conclusion: Most of the drugs prescribed were in the form of drops. FDCs and antimicrobial use have been increasing in the management of ophthalmic diseases. Less numbers of drugs were prescribed by generic names.

Ocular side effects in tuberculosis patients receiving direct observed therapy containing ethambutol

Background: India is among the largest countries to implement the revised national tuberculosis (TB) control program (RNTCP). Ocular toxicity of ethambutol has been known since 1962. It can be halted with early detection and cessation of the contributing drug. Aims and Objectives: This study aims to detect early ocular toxicity of ethambutol in TB patients under directly observed treatment strategy (DOTS). Materials and Methods: This was a prospective cross-sectional study of 30 patients getting AKT including ethambutol along with isoniazid, rifampicin, and pyrazinamide under RNTCP?DOTS center at a tertiary care hospital. The detailed history, best-corrected visual acuity (BCVA), color vision, fundus examination, visual field, retinal nerve fiber layer (RNFL) thickness, and central subfield macular thickness were carried out in all patients pretreatment and then at the 2nd month of treatment. Results: The mean age of patient was 44.87 years. Reduced visual acuity from the baseline was noted at the second in 23.33% of the right eyes (P = 0.01) and 30% of the left eyes (P < 0.01). Mean temporal RNFL thickness was significantly reduced from baseline after 2 months of treatment (P = 0.046). No significant difference was observed with color vision and visual fields pre- and post-treatment. Conclusion: The assessment of BCVA, color vision, visual field, RNFL, and macular thickness is essential at baseline and thereafter at frequent intervals to detect early ethambutol toxicity and probable reversible visual loss.

Role of Atorvastatin in Dyslipidemia: A Clinical Study.

This clinical study aimed to see the efficacy of atorvastatin in the management of dyslipidemia. It was a randomized observational clinical study involving 30 patients diagnosed with dyslipidemia. The patients were administered atorvastatin 10 mg tablet once-daily at bedtime and followed up for 12 weeks. This drug achieved the desired lipid profile at the end of the 12th week. Statistically strongly significant results were obtained in all the lipid profile levels. Thus, the present study showed this drug to be effective in the treatment of dyslipidemia.

Per rectal diazepam therapy in convulsive disorders.

One hundred and twenty children with persistent convulsions (lasting > or = 10 min) were treated with per rectal diazepam (dosage: 0.2 to 0.7 mg/kg/dose). Another group of 100 age matched children with convulsions, along with those who did not respond to rectal therapy were given intravenous diazepam in a dosage of 0.2 to 0.3 mg/kg/dose. Rectal treatment was effective in 80.83% cases while intravenous diazepam was effective in 90% cases which is statistically just significant (p < 0.05). No significant difference was observed in the efficacy of two routes of administration in controlling convulsions of different clinical types and various etiological groups (p < 0.05), except for primary generalized type where intravenous route was more effective than the rectal one (p < 0.05). No significant side-effect was observed with rectal therapy. Among the 23 (19.17%) children in whom rectal therapy failed, 12 (10%) responded to intravenous diazepam while the remaining 11 (9.17%) cases were resistant to both routes of administration.

Endocrine regulation of calcium and phosphate in rat eye lens and its significance in cataract formation.

Parathyroid hormone (PTH), calcitonin (CT)and calciferol (Vit. D3) operate synchronously to maintain a balance between calcium and phosphate levels in serum. An aberration of specific steps in the homeostatic process results in hypo/hyper phosphatemia. These aberrations may eventually lead to several diseased states. PTH and Vit. D3 induced hypercalcemia can, however, be significantly inhibited by calcitonin (CT). These findings have been correlated with the levels of calcium and phosphate obtained from human senile cataractous lenses of cortical and nuclear types. The comparison of the results indicate that amongst these three hormones PTH is most vulnerable in leading towards conditions for possible cataract formation in rat lens.

Role of fine needle aspiration cytology in the diagnosis of tubercular lymphadenitis.

The need for a rapid diagnosis of the cervical lymphnodes presenting to the surgeon in the out patient department resulted in this study. A total of 123 cases were studied to evaluate Fine Needle Aspiration Cytology as a diagnostic procedure and a diagnostic accuracy of 89.77 per cent was achieved in tubercular lymphnodes. FNAC along with Mantoux test and Erythrocytic sedimentation rate (ESR) gave an over all diagnostic accuracy of 97.72 per cent. Thus the role of FNAC as a safe, quick and reliable procedure in the diagnosis of tubercular lymphadenitis was established.