Practice towards disposal of medicines (unused/expired drugs) among the patients visiting tertiary care teaching hospital in Haryana, India

Background: Awareness towards improper disposal of medicines and its hazardous impact on environment is one of the major issues which we are neglecting but needs to be focused. In general, expired medicines/waste medicines/ left out medicines are disposed in the garbage or, rinse in sink or flushed down toilet, which ends up in the water system and have a potential effect on ecosystem. With this background, the present study was conducted to assess the practice towards disposal of medicines (Unused/Expired Drugs) among the patients visiting tertiary care teaching hospital in Haryana.Methods: This study was a descriptive, cross-sectional study conducted through face-to-face interviews by using a validated structured Questionnaire in patients attending the OPD of PGIMS, Rohtak, Haryana. A total of 150 patients participated in this study.Results: Among the 150 Patients participated in the study, 94 were male and 56 were female. Most common class of medicines used were NSAIDS (34%). About the practice of disposal of medicines 62% of them threw into the dustbin (household garbage) 18% into the toilet/sink. About consequences of improper disposal (55%) of them answered that they were not aware. The most common reason for left out medicines in home was incompletion of the course due to getting relieved from disease (50%). Most common way of procuring medicine was purchased on prescription and surprisingly only 30% participants checked the expiry date of medicine before procuring.  Among the participants 75% said that government should be responsible to create awareness for proper disposal of unused medicines.Conclusions: The present study brought out the current status and lacuna towards the disposal of medicines. Patients do not use all the medications and there is lack of knowledge about awareness of disposal of medicines and its consequences

Prescription pattern of antiepileptic drugs in indoor patients at tertiary care hospital in Haryana, India

Background: Epilepsy is a challenging medical problem in India with an annual incidence of 27.27 per 100,000 population and prevalence of 572.8 per 100,000. People with epilepsy require prolonged treatment and monitoring. The main goal in the treatment of epilepsy should be adequate control of seizures, without causing any life-threatening reactions due to the medications. This study was done to get an insight into the prescription pattern of anti-epileptic drugs (AEDs) in different types of epilepsy.Methods: A prospective study was carried out for six months (Feb to June 2016) in admitted patients in super speciality ward (Lala Shyam Lal) in neurology department of PGIMS, Rohtak, Haryana. The prescription data of 100 patients of seizures was analysed.Results: Idiopathic generalised epilepsy was commonest type of epilepsy (42%) and sodium valproate was the commonest drug prescribed for its treatment (66.66%) followed by phenytoin (23.33%) Symptomatic epilepsy was second commonest seizure (30%) and phenytoin (60%) was the commonest drug prescribed for it followed by sodium valproate (30%). Common adverse effects associated with anti-epileptic drugs (AEDs) were nausea, drowsiness, weight gain, diplopia and ataxia.Conclusions: Idiopathic generalized epilepsy was the commonest type of epilepsy recorded and sodium valproate was the commonest prescribed drug

Trigeminal neuralgia: recent approach in classification, diagnosis and management

Pain and fear of pain continue to be the commonest and strongest motivation for the people to seek facial pain treatment. Pain is a personal experience of the sufferer that cannot be shared and wholly belongs to the sufferer. Trigeminal neuralgia (TN) is a notable facial pain disorder resulting in periodic severe pain that produces one of the most severe kinds of pain known to mankind. Treatment of this debilitating condition may be varied, ranging from medical to surgical interventions. However antiepileptic drugs are commonly used for its treatment. This article brings out the recent approaches in diagnosis and treatment of trigeminal neuralgia

RECENT ADVANCES INPHARMACOTHERAPY OF ALZHEIMER’S DISEASE

The management of Alzheimer's disease (AD) has been a long-standing challenge and area of interest. Advances in knowledge of the pathogenesis of disease and an increase in disease burden have prompted investigation into innovative therapeutics over the last two decades. Current approved therapies are symptomatic treatments having some effect on cognitive function. Therapies that target β-amyloid (Aβ) have been the focus of efforts to develop a disease modification treatment for AD but these approaches have failed to show any clinical benefit so far. Beyond the 'Aβ hypothesis', there are a number of newer approaches to treat AD. This short review will summarize approved drug therapies, recent clinical trials and new approaches for the treatment of AD

New corona virus: is just a tip of iceberg?

The world is again experiencing a global viral epidemic of zoonotic origin. As of March 30, 785807 confirmed cases of coronavirus disease 2019 (COVID-19) and 37820 deaths had been reported in more than 120 countries. Strenuous efforts are being made by various countries of the world to halt transmission through shutting down transport, quarantining entire cities and enforcing the use of face masks. International flights have been cancelled and affected cruise ships quarantined. As in all outbreaks, there is an urgent need to develop effective diagnostics, therapeutics and vaccines. Several experimental diagnostic platforms are already in use in China and elsewhere. The whole-genome sequence of SARS-CoV-2 has been obtained and shared widely. Several potential treatments have been proposed, however, no antiviral treatment has been approved for the novel coronavirus, and despite two outbreaks of novel coronaviruses in the past two decades, vaccine development is still in its infancy

A COMPREHENSIVE ANALYSIS OF DRUG PRESCRIBING PRACTICES OF DOCTORS AND COMPLETENESS OF PRESCRIPTION IN A GOVERNMENT MEDICAL COLLEGE IN NORTHERN INDIA

Objective: This study was designed to analyze the drug prescribing practices of doctors and completeness of prescriptions in a government medical college in Northern India. Methods: A total of 2155 prescriptions were evaluated for adequacy of information related to prescribed drugs and completeness of information related to patients and doctors. Results: The weight of the patient was written only in 1.90% prescriptions. The diagnosis was not written on 43.85% prescriptions. A total number of drugs prescribed in all the prescriptions was 6998. The average number of drugs per prescription was found to be 3.25±0.24. Out of these, 64.10% were prescribed by brand names. About 69.14% of drugs were prescribed in the form of tablets. Route of administration was not found to be mentioned for 86.08% drugs. For 53.90% drugs, dose was not mentioned. The name of the prescribing doctor was mentioned in 1.95% prescriptions only. Conclusion: The study revealed that many prescriptions lacked crucial components of information pertaining to the drugs prescribed and the prescribing doctor. There is a vast scope for improvement by the prescribers

COMPARISON OF THE EFFECTS OF ANTIDEPRESSANTS ON COGNITION FUNCTIONS IN PATIENTS OF MAJOR DEPRESSIVE DISORDERS IN TERTIARY CARE HOSPITAL IN HARYANA

Objective: Depression is one of the most common mood disorders. Patients with major depressive disorder (MDD) usually present alterations in various cognitive functions. Several cost-effective interventions have shown favorable recovery and positive outcomes in the care and management of depression. The objective of the study was to compare the effect of fluoxetine (selective serotonin reuptake inhibitors), and venlafaxine (serotonin-norepinephrine reuptake inhibitors) on cognitive functioning in patients with MDD. Methods: This prospective, single-blinded, randomized, and comparative interventional clinical study was conducted in a tertiary care hospital in Haryana. Fifty-two patients of MDD (ICD-10) were randomly divided into two groups: Group F and Group V, allocated to receive fluoxetine and venlafaxine, respectively. The assessment was done during the enrolment and at the end of the 3rd, 6th, 9th, and 12th weeks of treatment using the ABC-Hamilton Depression Rating Scale (HAM-D) and Montreal Cognitive Assessment (MoCA) Scale. Statistical Analysis Used: The intragroup analysis was performed using repeated measures ANOVA while intergroup analysis was performed using unpaired “t”-test. p<0.05 was considered statistically significant. Results: Mean HAM-D score was clinically as well as statistically significant at the end of the 12th week of treatment as compared to baseline in both the groups while on the intergroup comparison, there was no statistically significant difference in both groups. The mean MoCA score was (25±2.19) in Group F and (23.76±6.97) in Group V at the end of the 12th week. On intergroup analysis at the 12th week, a statistically significant improvement in cognitive functions was observed in patients Group F as compared to Group V (p<0.05). Conclusions: The study of fluoxetine comparatively better improves cognition functions as compared to venlafaxine

ORA ANTIBIOTIC PROPHYLAXIS USE IN PATIENTS ADMITTED IN GENERAL SURGERY DEPARTMENT AT TERTIARY CARE TEACHING HOSPITAL IN HARYANA.

  Background: Antimicrobial agents are among the most widely used and misunderstood medications. Antibiotic-resistant bacteria have emerged as an unavoidable result of extensive use of antimicrobial medications, fuelling an ever-increasing demand for new treatments. Antimicrobial drug development, on the other hand, has slowed drastically, with only a handful of new drugs, few of which are unique, being developed, being introduced into clinical practice each year. The greatest strategy to control resistance is to reduce incorrect antibiotic use. Despite growing knowledge of the dangers of antibiotic abuse, overprescribing is nevertheless common, owing to patient demand, physician time constraints, and diagnostic ambiguity. If advances in the treatment of infectious diseases are to be maintained, physicians must become wiser and more resourceful. Methods: The present study was a prospective observational study conducted in the department of pharmacology in collaboration with the department of Surgery with the prior approval of Institutional Ethical committee. All data were retrieved from the patients’ case records. Using a convenient sampling method 100 adult patients who underwent surgical procedures in MMIMSR during the study period were taken. Results: A total of 100 patients admitted to the general surgery department of MMIMSR fulfilling the inclusion and exclusion criteria were enrolled. Out of 100 patients, 52(52%) were male and 48(48%) were female patients who underwent surgery and majority of the patients enrolled are between 48-58years (40%) years of age. Cholecystectomy (28%) was the most frequent performed surgery type followed by hernial repair (24%) and haemorrhoidectomy (14%) Among all cases, surgical antibiotic prophylaxis was recommended in 93(93%) patients. The most preferred route of administration of surgical antibiotic prophylaxis were parenteral route 100 (100%) and Ceftriaxone was most commonly prophylactically prescribed antibiotic. Conclusion: Surgical site infection are the most common nosocomial infections in surgical patients accounting for prolonged hospital stay, mortality and increased cost of care. According to the analysed results of our study and from view of literature present study provides us patterns of antibiotic usage in patients admitted in surgery wards

Prescription pattern of antiepileptic drugs in indoor patients at tertiary care hospital in Haryana, India

Background: Epilepsy is a challenging medical problem in India with an annual incidence of 27.27 per 100,000 population and prevalence of 572.8 per 100,000. People with epilepsy require prolonged treatment and monitoring. The main goal in the treatment of epilepsy should be adequate control of seizures, without causing any life-threatening reactions due to the medications. This study was done to get an insight into the prescription pattern of anti-epileptic drugs (AEDs) in different types of epilepsy.Methods: A prospective study was carried out for six months (Feb to June 2016) in admitted patients in super speciality ward (Lala Shyam Lal) in neurology department of PGIMS, Rohtak, Haryana. The prescription data of 100 patients of seizures was analysed.Results: Idiopathic generalised epilepsy was commonest type of epilepsy (42%) and sodium valproate was the commonest drug prescribed for its treatment (66.66%) followed by phenytoin (23.33%) Symptomatic epilepsy was second commonest seizure (30%) and phenytoin (60%) was the commonest drug prescribed for it followed by sodium valproate (30%). Common adverse effects associated with anti-epileptic drugs (AEDs) were nausea, drowsiness, weight gain, diplopia and ataxia.Conclusions: Idiopathic generalized epilepsy was the commonest type of epilepsy recorded and sodium valproate was the commonest prescribed drug

SAFETY MONITORING OF COVID-19 VACCINE: IN A TERTIARY CARE HOSPITAL IN HARYANA

Objective: The present study aimed to ensure the safety and related potential adverse effects following ChAdOx1 nCoV-19 vaccination (AZD1222) in a scenario when numerous vaccines have been approved on emergency basis by the WHOand other regulatory agencies to prevent the widespread of COVID -19 infection and to decrease the associated mortality and morbidity. Methods: This study was an open, non-comparative, non-interventional, observational study conducted on healthcare workers of BPS Govt. medical college for women and elderly people who received the first dose of COVID-19 vaccinationChAdOx1 nCoV-19 vaccine (AZD1222) by conducting their interviews and recording the data Results: Between January and March 2021, a total of 1907 participants were enrolled in this study. Out of 1907 recipients, 70 recipients reports adverse drug event following vaccination. Myalgia (0.629%), headache (1.31%), fever (≥ 37.5°C, 0.839%) and fever with chills (≥ 37.5°C, 1.048) were the most common adverse events after first dose of vaccination of ChAdOx1 nCoV-19 vaccine (AZD1222. Throat irritation (0.209 %) and Generalised itching (0.262) were the least common adverse events. Conclusion: ChAdOx1 nCoV-19(Astrazeneca) has an acceptable safety profile as observed in this study. To our knowledge, very few studies are done that review the safety of COVID-19 vaccines. Further safety data from a larger sample size and of longer duration are warranted to establish safet