ABSTRACT
Background Drug utilization studies are important and considered as a potential tool for the evaluation of health care systems. The goal of drug utilization research studies should be to assess whether drug therapy is rational or not. Objective The main aim of this article is to analyze the different types of epilepsy and their drug utilization pattern in children with epilepsy at the Department of Pediatrics and evaluate the extent of older and newer antiepileptic drugs (AEDs), either as monotherapy or polytherapy in pediatric age groups. Materials and Methods To look into the sociodemographic profile of children with epilepsy, the type of epilepsy was diagnosed along with drug utilization pattern in children attending both outpatient and inpatient department of pediatrics. Demographic details were collected according to modified Kuppuswamy scale. Disease characteristics such as type of epilepsy, onset, duration, time since last attack, family history, comorbid conditions, monotherapy/polytherapy, dose, and duration of treatment were noted. Investigations such as electroencephalography, magnetic resonance imaging, and computed tomographic scan if any were recorded. Results In this pilot study, we have 100 patients, younger than 18 years, with confirmed cases of epilepsy, receiving AEDs either monotherapy or polytherapy. Male predominance was 56%, and 60% were from rural areas and 40% were from urban areas. As per the modified Kuppuswamy scale, we analyzed socioeconomic class of these 100 patients and found that 40% belong to lower-middle-class family. Nearly 51% were diagnosed with generalized tonic clonic seizures, 30% were with febrile seizures, while focal, partial, absence, and myoclonic seizures, and hot water epilepsy were less in percentage. Almost 83% received monotherapy, while only 17% received polytherapy. Among monotherapy, 51.80% received older AEDs and 48.20% received newer drugs. Conclusion Although epilepsy can be controlled and managed effectively with older AEDs, an experience in management with newer AEDs is required to offer an additional advantage to patients to have better safety profile.
ABSTRACT
CONTEXT: Quality of life (QOL) assessment in patients with epilepsy (PWE) is increasingly recognized as an important component in the management of epilepsy. AIMS: The objective of the present study was to assess influence of sociodemographic, clinical and pharmacotherapy characteristics collectively on QOL in adult PWE. SETTINGS AND DESIGN: This was a cross-sectional, observational study in patients with confirmed diagnosis of epilepsy. MATERIALS AND METHODS: QOL was assessed using modified QOLIE-10 questionnaire for epilepsy. Univariate and multiple regression analysis were done to determine factors associated with poor QOL, respectively. RESULTS: There were 451 PWE, with a mean age 27.3 ± 8.15 years, 251 (56%) males and 191 (42%) had monthly income < 5000 Indian national rupees (INR)/month. The QOLIE score was 64.1 ± 15.97 (Mean ± SD). The univariate analysis showed factors such as lower monthly income, focal epilepsy, seizure frequency, antiepileptic drug (AED) polytherapy, conventional AEDs and frequent adverse drug reactions (ADRs) had significant negative influence on various domains of QOLIE-10 questionnaire. Multiple regression analysis showed seizure frequency as a significant predictor of most QOL domains and overall score, while ADRs as a significant predictor of all the domains. Seizure type was a predictive factor for domains like emotional well-being and overall score. CONCLUSION: Present findings showed patients on monotherapy had better QOL while those having lower monthly income, having focal epilepsy and who received conventional AEDs had negative influence on QOL scores. Further, higher seizure frequency and occurrence of ADRs were significant predictors of all the domains of QOL in PWE.
ABSTRACT
OBJECTIVES: 1) To evaluate the analgesic effect of atorvastatin and simvastatin. 2) To compare analgesic activity of these with an established drug tramadol. MATERIALS AND METHODS: Healthy Albino rats were taken. They were randomly divided into 4 groups of six animals each. Group I: Normal Saline (0.5 ml), Group II: Tramadol (10 mg/kg BW), Group III: Atorvastatin (10 mg/kg BW) and Group IV: Simvastatin (10 mg/kg BW). The animals were subjected to 3 different tests at different interval of time. The tests conducted were tail clip method, Eddy's hot plate and hot water tail immersion method. RESULTS: Atorvastatin and simvastatin differ significantly from control hence they have analgesic action and even at any of the time intervals they do not differ significantly from tramadol; hence their analgesic effect is nearly comparable to tramadol. The results of the present study indicate that atorvastatin and simvastatin have analgesic action. CONCLUSION: These statins are found to have analgesic effect other than hypolipidemic activity and can be used in these patients. However further study has to be undertaken in a broader way.
