A comparative survey study on current prescribing trends in non-steroidal anti-inflammatory drugs among practitioners in private set up and tertiary care teaching rural hospital.

Background: The study was conducted to compare the current prescribing trends of Non-Steroidal Anti-inflammatory drugs (NSAIDS) among private practitioners and practitioners at tertiary care teaching rural hospital. Methods: The prospective survey study was carried out by obtaining response to feedback questionnaire related to use of NSAIDs from 25 private & 25 tertiary care practitioners. Results: NSAIDs use was routine amongst private (66%) and tertiary care (77.6%) practitioners. Preferences of tertiary care practitioners were paracetamol (36%), diclofenac (20%), aceclofenac (20%), ibuprofen (20%) and etoricoxib (4%) while that of private practitioners were ibuprofen (40%), paracetamol (32%), diclofenac (16%) and aceclofenac (12%). Use of Fixed Dose Combinations (FDC) was 72% in private and 68% in tertiary care practitioners. While prescribing FDCs, private practitioners preferred NSAIDs + NSAIDs (100%) over NSAIDs + muscle relaxants (44.44%), NSAIDs + Serratiopeptidase (55.56%), and NSAIDs + antacids (44.44%) similarly tertiary care practitioners also preferred NSAIDs + NSAIDs (100%) over NSAIDs + muscle relaxants (47.06%), NSAIDs + Serratiopeptidase (36%), and NSAIDs + antacids (28%). Of the NSAIDs + NSAIDs combination ibuprofen + paracetamol (70%) was preferred by private practitioners and diclofenac + paracetamol (61%) by tertiary practitioners. Paracetamol was safely used during pregnancy by both groups. Adverse effects observed included gastritis (98%), urticaria (32%), and anaphylaxis (2%), although no fatality was observed. Conclusion: Not much of a difference was observed in prescribing habits of both groups. Though beneficial and routinely prescribed, NSAIDs with equal risk potential were observed to be cautiously used with appropriate knowledge amongst both the groups.

Drug utilization in clinical conditions: an update on its essentials.

Drug utilization studies may be defined as studies of the marketing, distribution, prescription and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences. Drug utilization studies can provide highly valuable information, at a reasonable price, on the costs and effects (harmful and beneficial) of drugs. Such studies make available much useful information including indirect data on morbidity, the pharmaceutical component of the treatment cost of an illness, therapeutic compliance, the incidence of adverse reactions, the effectiveness of drug consumption and the choice of comparators. This information can be of great use in the subsequent elaboration of pharmacoeconomy studies, or in the selection of problematic areas in which these studies may be applied. Pharmacoeconomy studies, in turn, can be used to discover the economic repercussions of inappropriate prescribing and to quantify the cost effectiveness of various therapeutic interventions. The use of drug utilization studies in conjunction with pharmacoeconornic analysis can result in more cost effective utilization of medicines and a better utilization of pharmacoeconomy methods, both of which contribute to a more rational use of drugs.

A prospective study on the use of magnesium sulfate in prevention and management of eclampsia with emphasis on adverse drug reactions.

Introduction: The hypertensive disorders in pregnancy are the leading causes of maternal and perinatal mortality. Management of preeclampsia and eclampsia remains controversial even today. Several drugs with different regimens are available at present. As a consequence; women are treated in various ways by different regimens. Aim: Our work aimed to study the use of various magnesium sulfate regimens used in management of eclampsia in a tertiary care teaching rural hospital. Methods: A prospective, observational, non-interventional study was carried out among the eclamptic patients admitted to obstetrics ward. After explaining the purpose and method of study, through the patient information sheet, patients willing to sign the informed consent form were enrolled for the study. Relevant data was gathered from their case files and by direct interview with the patients that were recorded in the case record form. Results: Of the 35 cases of eclampsia recorded during the study period, we observed that all the patients were treated with Pritchard’s regimen of Magnesium Sulfate. It was noticed that there was improvement in all the patients with no adverse drug reactions recorded during the time of management. Conclusion: Maternal and perinatal mortality can be reduced to major extent by prevention of eclampsia. Prompt diagnosis and institution of therapy by selecting an ideal anticonvulsant is essential as the maternal and perinatal mortality progressively rises with increase no of convulsions. Magnesium Sulfate is a potent anticonvulsant with mild antihypertensive activity with less adverse effects.

A survey study on use of over the counter (OTC) drugs among medical students, nursing and clerical staff of a tertiary care teaching rural hospital.

Aim: The study was conducted to evaluate use of over the counter (OTC) drugs among the medical students, nursing and clerical staff of tertiary care teaching rural hospital to determine the awareness and disadvantages on use of OTC. Methods: Responses to a feedback questionnaire covering various aspects on usage of OTC drugs were obtained from 100 medical students, 100 nursing and 100 clerical staff. Results: Among 300 respondents, 84% used OTC, commonly purchased by self. Majority of them started self medication within 2 days of their illness. The frequently reported illness that prompted self-medication included headache, cough and cold, fever, generalised weakness, acidity, dysmenorrhoea, and sleep disturbances. Majority of them obtained OTC by mentioning name of drug (81%), 35% by telling symptom and 15% by showing old prescription. We found that 87% people share OTC among relatives and friends. Conclusions: Usage of OTC was highest amongst medical students and nursing staff. Time consumption for consultation, the consultation fees and frequent visits were the commonly mentioned reasons for self medication. It was analysed that none of the clerical staff were aware of the drug, dose, frequency of administration and adverse reactions. While very little awareness of medication was found even among nursing staff and medical students. Therefore it is suggested that the public has to be educated on the type of illnesses to be self-diagnosed and medicated, dangers of OTC on misuse which would possibly lead to delay in detection of more serious underlying ailment and timely medication.

A prospective survey study on premenstrual syndrome in young and middle aged women with an emphasis on its management.

Premenstrual syndrome (PMS) is defined as the recurrence of psychological and physical symptoms in the luteal phase, which remit in the follicular phase of the menstrual cycle. Symptoms of which fall in three domains: emotional, physical and behavioural e.g. irritability, anger, headache, fatigue, food cravings etc. The survey study of was conducted among 50 young & 50 middle aged women of S.B.K.S Medical Institute and Research Centre to find the prevalence of premenstrual syndrome with an emphasis on its management. Responses to a feedback questionnaire covering various aspects related PMS were obtained from 50 participants belonging to each group. The participants belonged to different range of literacy. It was found that 42% faced PMS regularly, while 58% occasionally. Of the 100 participants 68% suffered with backache, 64% leg cramps, 62% fatigue, breast tenderness and anger whereas 58% suffered with anxiety and generalized body ache. Of all the sufferers only 34% had received the treatment for PMS. Irrespective of the age PMS is common problem faced by women. With our study we observed that literacy has not mattered in the management of this health problem. Since there are reports stating that the severity of PMS can hamper the daily routine and even lead to suicidal tendency, it is essential that awareness programs need to be conducted to address the importance of managing the issue by pharmacological and non-pharmacological methods.