Assessment of prescribing pattern of drugs and completeness of prescriptions as per the World Health Organization prescribing indicators in various Indian tertiary care centers: A multicentric study by Rational Use of Medicines Centers-Indian Council of Medical Research network under National Virtual Centre Clinical Pharmacology activity.

OBJECTIVE: The rational use of medicines as per the World Health Organization (WHO) should be practiced globally. However, data regarding the completeness of the prescriptions and their rational use is lacking from developing countries like India. Thus, the aim of this study was to assess the prescribing patterns of drugs and completeness of prescriptions as per WHO core drug use and complementary indicators to provide real-life examples for the Indian Council of Medical Research (ICMR) online prescribing skill course for medical graduates. METHODS: Prescriptions of the patients, fulfilling inclusion criteria, attending Outpatient Departments of various specialties of tertiary care hospitals, were collected by thirteen ICMR Rational use of medicines centers located in tertiary care hospitals, throughout India. Prescriptions were evaluated for rational use of medicines according to the WHO guidelines and for appropriateness as per standard treatment guidelines using a common protocol approved by local Ethics committees. RESULTS: Among 4838 prescriptions, an average of about three drugs (3.34) was prescribed to the patients per prescription. Polypharmacy was noted in 83.05% of prescriptions. Generic drugs were prescribed in 47.58% of the prescriptions. Further, antimicrobials were prescribed in 17.63% of the prescriptions and only 4.98% of prescriptions were with injectables. During the prescription evaluation, 38.65% of the prescriptions were incomplete due to multiple omissions such as dose, duration, and formulation. CONCLUSION: Most of the parameters in the present study were out of the range of WHO-recommended prescribing indicators. Therefore, effective intervention program, like training, for the promotion of rational drug use practice was recommended to improve the prescribing pattern of drugs and the quality of prescriptions all over the country.

An evaluation of impact of educational interventions on the technique of use of metered-dose inhaler by patients.

OBJECTIVES: The objective of this study is to evaluate the impact of two educational interventions that are demonstration versus pictorial Leaflet in patients using metered-dose inhaler (MDI). MATERIALS AND METHODS: This interventional study was done in patients who were prescribed drugs through MDI at Tuberculosis and Chest Department. The patients were enrolled in Group A or Group B as per random number table method. The method of use of MDI was assessed using a checklist based on the technique described in the WHO Guide to good prescribing. Patients in Group A were taught the use of MDI by demonstration of the technique by the investigator. Patients in Group B were educated about the technique by a pictorial leaflet based on the technique. Patients were followed up after 15 days and assessed for correct technique for use of the MDI. RESULTS: A total 100 patients were included in the study and were allotted to Group A (47) and Group B (53). Ninety-five percent of the patients had been taught by the treating physician about the method of use of MDI. All the patients at the baseline placed the lips tightly around the mouthpiece and held the aerosol as indicated in the manufacturer's instructions while the step least followed was coughing up the sputum before inhalation. The average steps correctly followed by the patients in Group A and B at baseline were 5.17 ± 2.07 and 5.11 ± 2.04, respectively. These improved significantly to 9.19 ± 0.67 and 6.67 ± 0.63 in Group A and B, respectively, postintervention. The five essential steps of using MDI were followed by 25.53% and 26.41% patients preintervention. An improvement in the technique of use of MDI was observed in 85.11% and 49.06% patients (P = 0.003) postintervention. All the ten steps of the technique were followed by 34.04% patients from Group A and none from Group B at postintervention evaluation (P = 0.0001). CONCLUSION: The inhalation technique for the use of MDI used by the patients is inappropriate. Educational interventions such as demonstration or pictorial leaflet help ensure a better use of the MDI.

A study of the use of drugs in patients suffering from psoriasis and their impact on quality of life.

OBJECTIVE: To study the use of drugs in patients suffering from psoriasis and their effect on quality of life (QOL). MATERIALS AND METHODS: This was a prospective, observational study carried out in newly diagnosed patient of psoriasis at Department of Pharmacology and Outpatient Department of Skin and Venereal diseases at tertiary care teaching hospital, and patients were divided into three groups: Group A: topical therapy alone, Group B: methotrexate with topical therapy, and Group C: cyclosporine with topical therapy. The efficacy of drug was measured using Psoriasis Area Severity Index (PASI). QOL was measured using Psoriasis Disability Index. Patients were followed up at 1 month and 6 months of treatment. Statistical analysis was done using analysis of variance (ANOVA) test. RESULTS: A total 126 patients were enrolled, out of which 114 patients completed the study. PASI score was reduced significantly (P < 0.001) in each treatment group and QOL score was significantly (P < 0.001) decrease in Group B and C as compared to baseline at the end of 6 months. A significant (P < 0.001) reduction in PASI score and QOL was observed in patients of Group B and C as compared to Group A. Correlation between efficacy and QOL was not significant in all three treatment groups. CONCLUSION: Combination therapy (topical + systemic) is more efficacious and associated with significant improvement of QOL as compared to topical therapy alone. Methotrexate and cyclosporine are equally efficacious in treating and improving the QOL in patients suffering from psoriasis.

Self-medication for Acne among Undergraduate Medical Students.

AIMS: This study aims to evaluate the knowledge and pattern of self-medication for acne among undergraduate medical students at a tertiary care teaching hospital. MATERIALS AND METHODS: This cross-sectional study was conducted in II MBBS (Group A), III MBBS Part I (Group B), and III MBBS Part II (Group C) students. Prevalidated questionnaire about knowledge, attitude, and practice of self-medication were administered to participants. Data were analyzed using one-way analysis of variance and Chi-square test. RESULTS: Out of 582 students who responded to questionnaire, 518 suffered from acne. Self-medication practice was observed in 59.2% students. Significantly higher number of female students practiced self-medication (P < 0.0001). Most common source of information was seniors/friends/family members (34.2%). The mildness of illness (42.3%) was the most common reason of self-medication. A total mean score of knowledge was significantly higher in Group C as compared to Group A (P < 0.001) and Group B (P < 0.05). Allopathic medication was preferred by 69.8% students. Seventy-five percentage students read leaflet/package insert/label instruction and expiry date of the medicines. CONCLUSIONS: The participating students lack the knowledge about self-medication for acne. Adequate knowledge and awareness about the appropriate use of medication will reduce the practice of self-medication and improve rational prescribing.

Novel 2-pyrazoline derivatives as potential antibacterial and antifungal agents.

The 1,3,5-trisubstituted-2-pyrazolines were synthesized by refluxing isoniazid with various substituted diarylchalcones in N,N-dimethylformamide at 120-140 degrees . The physical and spectral data such as M.P., R(f), elemental analysis, IR, NMR and Mass was obtained for the synthesized compounds and the structures were confirmed. The screening of the synthesized compounds for antimicrobial activity was performed against Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, Escherichia coli and Aspergillus niger.