A study of drug utilization pattern in patients with hypertension in a tertiary care hospital

Background: Hypertension, a leading global health concern, poses significant risks to vital organs such as the heart, brain, and kidneys. Effective management remains a challenge, especially in countries like India, where cardiovascular diseases are a major contributor to mortality. This study aimed to evaluate the drug utilization patterns of antihypertensive drugs and associated prescribing practices in a tertiary care teaching hospital. Methods: A hospital-based cross-sectional descriptive study was conducted from January to October 2023 in the Departments of Medicine and Cardiology. The study included patients diagnosed with hypertension aged 18 years or older. Data on prescribed antihypertensive drugs, including drug type, dosage and comorbidities, were collected and analyzed. Results: A total of 230 prescriptions were analyzed, with 75.59% of patients receiving monotherapy. Amlodipine was the most commonly prescribed drug, used in 87.5% of monotherapy cases. Combination therapies were prescribed to 24.41% of patients, with the most common combinations being Amlodipine + Atenolol and Losartan + Hydrochlorothiazide + Amlodipine. Diabetes mellitus was the most frequent comorbidity observed, affecting 60 patients. A significant portion of prescriptions (59%) was written using brand names, and 41% were written using generic names. Conclusion: Future research should focus on enhancing patient adherence, optimizing treatment regimens, and continuously monitoring prescribing patterns to improve hypertension management and reduce associated health burdens

Addressing cardio-metabolic risks in type 2 diabetes: evidence-based insights on efpeglenatide

Type 2 diabetes (T2D) is a chronic metabolic disorder linked to significant complications, including cardiovascular disease (CVD) and chronic kidney disease (CKD). Efpeglenatide, a long-acting glucagon-like peptide-1 receptor agonist (GLP-1 RA), has emerged as a promising therapy for addressing glycemic control, weight management, and cardio metabolic risks. A systematic review of randomized controlled trials (RCTs) was conducted using PRISMA guidelines. Searches in PubMed, Google Scholar, and Science Direct identified studies on efpeglenatide impact on T2D outcomes. Data on efficacy, safety, dose-response, and combination with sodium-glucose cotransporter-2 (SGLT2) inhibitors were extracted and analyzed. Out of 843 studies screened, 10 were included. The AMPLITUDE-O trial showed a 27% reduction in major adverse cardiovascular events (MACEs) (hazard ratio [HR]: 0.73, p=0.007) and significant renal benefits (HR: 0.68, p<0.001). Phase 2 trials demonstrated HbA1c reductions (0.6%-1.2%) and weight loss (up to 7.5%). Gastrointestinal side effects were common but mild to moderate, with no major safety concerns. Sub-analyses indicated that combining efpeglenatide with SGLT2 inhibitors did not diminish its efficacy, suggesting potential synergy in reducing cardio metabolic risks. Efpeglenatide demonstrates robust efficacy in glycemic control, weight loss, and reducing cardiovascular and renal risks, with a tolerable safety profile. Its long-acting properties and compatibility with SGLT2 inhibitors support its use in comprehensive, individualized T2D management. Further research is warranted to refine dosing strategies and evaluate long-term outcomes in diverse patient populations

Analysis of the drug package inserts in India as per the CDSCO guidelines

Background: The package insert (PI) is provided along with the drug in its manufactured container by pharmaceutical companies. This is one of the ways to provide essential information related to drugs to healthcare professionals and patients. Pharmaceuticals follow the regulations mentioned in the drugs and cosmetics act (1940) and rules (1945) under Schedule D and the central drugs standard control organisation (CDSCO). Methods: A cross-sectional, observational, prospective study was conducted at Shree Krishna Hospital, Anand, Gujarat. From December 2023 to January 2024, a total of 98 PIs were collected from pharmacy stores within the hospital. All PIs were analyzed according to CDSCO guidelines. Results: A total of 98 PIs were analyzed. After the analysis,>90% of the information is present in half of the parameters. There is 25-65% information present regarding the drug details in the rest of the parameters. Conclusions: Our study has revealed that the information on package inserts is currently inaccessible. If drug companies can present this crucial information in a manner that is easily accessible to patients, it has the potential to greatly improve compliance. In our country, where concerns regarding the quality of medicines arise, implementing high-quality package inserts can effectively address these concerns

Antibacterial prescription pattern and adverse drug reactions in childhood pneumonia

Background: Antibacterial drugs play an important role in the treatment of Pneumonia-a leading cause of death globally among children. To determine the class, dosing schedule, Adverse Drug Reactions (ADRs), selection criteria and World Health Organisation (WHO) prescribing indicators of antibacterials used for pneumonia. Methods: Following the Institutional Review Board (IRB) clearance, 18 months long descriptive study was conducted among 432 paediatric patients admitted with Pneumonia in a tertiary care center. Details on antibacterial prescription with selection criteria and associated ADRs were collected. Causality, preventability and severity of ADRs were assessed. WHO prescribing indicators were calculated. Data analysed using SPSS software. Results: Aminopenicillins (61.2%)  were the major antibacterial class prescribed and the major antibacterial was Ampicillin (34.6%) with dosage regimen 32-66 mg/kg Intravenously four times daily (34.4%) with mean treatment duration 3.6±1.26 days. Major route of administration was intravenous (57%) and 99% patients received empirical treatment. The ADRs reported were Gentamicin & Ampicillin induced Hypersensitivity reactions and Vancomycin induced Redman Syndrome. WHO prescribing indicators: Average number of antibacterials per encounter 2.42, Antibacterials prescribed by generic name 96.56%, Encounters with injection 98.37%, Antibacterials from Essential Medicines List (EML) 90.9%. Conclusions: Aminopenicillins were the major antibacterial class, Ampicillin was the major antibacterial, Inj. Ampicillin 32-66 mg/kg intravenously four times daily with mean duration 3.6±1.26 days was the commonest dosage regimen prescribed. Most antibacterials were from EML, prescribed in generic name, selected empirically and administered intravenously.  Three ADRs were reported. Prescribing indicators were calculated

Individual component analysis of gastrointestinal symptom rating scale for irritable bowel syndrome in irritable bowel syndrome patients treated with Bacillus coagulans SNZ 1969: additional findings from a randomized, double-blind, placebo-controlled study

This study evaluated the therapeutic efficacy of Bacillus coagulans SNZ 1969 (B. coagulans SNZ 1969) in patients with constipation-predominant irritable bowel syndrome (IBS-C) and diarrhea-predominant IBS (IBS-D). We conducted a randomized, double-blind, placebo-controlled trial in 80 patients (40 IBS-C, 40 IBS-D) who received either B. coagulans SNZ 1969 (500 million CFU) or placebo twice daily for 60 days. Assessments were performed at baseline and on days 30, 60, and 75. Here we present the additional findings of the individual components of Gastrointestinal Symptom Rating Scale for IBS (GSRS-IBS). Results demonstrated significant reductions in all individual components of GSRS-IBS (abdominal pain, bloating, constipation, diarrhea, and satiety) in both IBS-C and IBS-D patients treated with B. coagulans SNZ 1969 compared to placebo. In conclusion, B. coagulans SNZ 1969 found to be an effective therapeutic option for IBS, demonstrating broad efficacy across multiple symptom domains

Cost variation analysis of anti-epileptic drugs available in the Indian market

Background: Epilepsy is a chronic, noncommunicable disease of the brain affecting 50 million people worldwide. Out-of-pocket expenditure (OOPE) remains a major burden for Indian households, leading to poor adherence in epilepsy treatment. Many patients discontinue therapy due to high costs, worsening disease outcomes. This study aimed to analyse price variations among different brands of anti-epileptic drugs (AEDs) available in India. Methods: The prices in Indian rupees for all AEDs of same strength manufactured by different pharmaceutical companies in the Indian market were obtained from Current Index of Medical Specialities (CIMS) 3rd update 2024, Indian drug review (IDR) 2024 issue and National Pharmaceutical Pricing Authority (NPPA)-Pharma Sahi Daam. The cost ratio was calculated by dividing the price of the costliest brand by the price of the least costly brand. The percentage cost variation was determined by subtracting the minimum cost from the maximum cost, dividing it by the minimum cost and multiplying by 100. Results: Analysis of 1708 brands of 23 single AEDs and 112 brands of fixed dose combinations (FDCs) in India revealed wide cost variations. Clonazepam showed highest percentage cost variation and cost ratio among single drugs, while Oxcarbazepine and Sodium valproate had the lowest percentage cost variation and cost ratio, respectively. Conclusions: The study highlights significant cost disparities among different brands of AEDs, affecting patients’ OOPEs. Clinicians should therefore consider these price variations to prescribe cost-effective treatments, improving patient compliance and disease outcomes. The findings also emphasize need for regulatory measures to promote equitable and affordable drug pricing

An insight to kidney dialysis treatment

The kidneys are a pair of crucial organs that perform multiple functions in maintaining the cleanliness and chemical balance of blood. The two most common causes of kidney damage are high blood pressure and diabetes. The national kidney foundation recommends three simple tests: a blood pressure check, a spot check for protein or albumin in the urine, and calculation of glomerular filtration rate (GFR) based on a serum creatinine measurement. Ridding the blood of waste and extra water is done through the procedure of dialysis. It is basically used in patients with renal failure to create an artificial substitute for the lost kidney function. End-stage renal disease (ESRD) is a condition other referred to as ESRD, referring to complete or almost complete, irreversible kidney failure. If treatment is not received, uremia can cause a coma, seizures, and death. Patients may require dialysis or a kidney transplant if both kidneys fail completely

Formulation and characterization studies of microspheres

In the current scenario of delivering therapeutic agents to the target site requires an efficient drug delivery carrier which can delivery the drug only on the site of action in a sustained and controlled manner among many such carriers microspheres fulfill all the parameters for a potent drug carrier. Microspheres are free flowing powders consists of proteins or synthetic polymers that are biodegradable in nature ranging between 1–1000-micron size. A well-designed controlled drug delivery system can overcome some of the problems of conventional therapy an enhanced the therapeutic efficacy of given drug. Microspheres received much attention not only for prolonged release, but also targeted anticancer drugs. Microspheres can be manufactured by various type of material such as glass, polymers and ceramics microspheres. Microspheres are various types like bioadhesive microspheres, magnetic microspheres, floating microspheres, radioactive microspheres, polymeric microspheres are prepared by methods like spray drying, solvent evaporation, single emulsion, double emulsion, solvent extraction, quassi emulsion solvent diffusion. Microspheres will play a key role in novel drug delivery in the future by fusing together a variety of other strategies especially in diseased cells, diagnostics and act as supplements as miniature versions of diseased organ and tissues in the body

A retrospective analysis of the burden and treatment patterns of esophageal cancer over one year in a tertiary healthcare institution in the Western Himalayan region

Background: Esophageal cancer (EC) is a highly aggressive malignancy with a poor prognosis, particularly in advanced stages. By 2024, EC incidence is expected to increase by 63.5% over 2020. The objective of the study was to analyse the EC burden and treatment patterns in Dr. RPGMC, Kangra, Himachal Pradesh, Radiotherapy and Oncology Department, with a focus on palliative radiotherapy. Methods: A retrospective analysis of 83 patients treated at our institute between 2023 and 2024 for esophageal cancer (7.9% of all new cases). Patients received treatment in two groups: palliative (n=34) and radical (n=49). Analysis was done on demographic, histopathological, cancer staging, and treatment modalities data. Self-expandable metallic stent (SEMS) implantation, palliative chemotherapy, or radiotherapy were all considered forms of palliative care. It was evaluated if palliative radiotherapy improved dysphagia. Results: Almost 8% of all cancers were esophageal cancers. There were 30.1% women and 69.8% men, with an average age of 63.9±9.6 years. In 98% of cases, squamous cell carcinoma was found. Of the palliative patients, three had SEMS placement, nine had chemotherapy, and twenty-two had radiotherapy. Following radiotherapy, dysphagia improved in 63.6% of palliative cases, or 68% of cases. Alcohol consumption and smoking were prevalent among men (76%). Conclusions: The study highlights the burden of EC and the importance of tailored treatment strategies. While radical treatment remains the preferred approach, palliative care plays a crucial role in symptom management for advanced cases (alleviating dysphagia, improving QOL)

The efficacy of endoxifen in treating borderline personality disorder in young female patients: reports of two cases

This case reports presents two young female patients diagnosed with borderline personality disorder (BPD) who were treated with endoxifen. The report details their clinical presentations, previous treatment histories, the rationale for initiating endoxifen as adjunctive therapy, and the subsequent clinical outcomes. The objective is to understand the efficacy and safety of endoxifen in managing BPD symptoms, focusing particularly on impulsivity, mood fluctuations, and overall functional recovery