Economic burden of diabetes mellitus in western India: a hospital based study

Background: Descriptive cost of illness study can provide an overall picture of diabetes in monetary terms in developing country, which may serve as a vital source of information for health care organizations and planning bodies to plan and prioritize local health policies and schemes. The aim was to explore cost description of diabetes in a tertiary care hospital in Anand district of Gujarat, India.Methods: This was an observational study with one year follow up. Ethical approval was taken from IEC. Patients were recruited and were divided into three categories according to duration of diabetes; newly diagnosed cases as category I, diabetes since last 5 year as category II and since last 10 years as category III. All these patients were followed up with 4 visits. Cost was calculated into three components; direct medical, direct non-medical and indirect cost. Descriptive and regression analysis was done using SPSS version 17.0.Results: Total 90 patients were analyzed after 12 patients were lost to follow up, 30 in each category. Mean total cost was found to be 12391.84 INR. Contributions from direct medical cost, direct non-medical cost and indirect cost were 74%, 2% and 24% respectively. Maximum cost incurred was due to medicine cost (44.14%) followed by complication cost (43.34%).Conclusions: Heavy economic burden highlights the urgent need for the health care organizations to plan and prioritize policies and accordingly in prevention and management of diabetes and its complications

Prescribing pattern in a pediatric out-patient department in Gujarat

This study was carried out to find the medicine-prescribing pattern in children taking treatment in pediatric out-patient department of a tertiary care teaching hospital in rural Gujarat. Prescriptions of 606 patients were collected over a period of six months and analyzed for (i) average number of medicines per prescription, (ii) percentage of medicines prescribed by official names, (iii) essentiality status of medicines, (iv) appropriateness of medicines used and (v) cost of prescription. The average number of medicines per prescription was 3.72 ± 0.07 and 46.7% patients were prescribed up to 3 medicines. Of the 1483 medicines prescribed, 456 (30.7%) were prescribed by official names and 77.61% were essential. Only 20.13% prescriptions could be reckoned as most appropriate. Twenty percent of the total cost was on account of non-essential medicines, of which 95% was contributed by non-essential fixed dose drug combinations

Newer Practice of Informed Consent Process of Clinical Trials in India

10.1353/asb.2016.0027Asian Bioethics Review84327-33

PRESCRIBING PATTERNS OF CEPHALOSPORIN IN CHILDREN FOLLOWING IMPLEMENTATION OF ANTIBIOTIC STEWARDSHIP PROGRAM IN A TERTIARY CARE HOSPITAL AT WESTERN INDIA

Objective: The objective of the study was to study the prescribing patterns of cephalosporins in children following the implementation of Antibiotic Stewardship Program (ASP) in a tertiary care hospital at western India. Methods: This was an observational study of records using data of pre- and post-implementation of ASP. Data were collected from case files of children admitted to pediatric wards in the years 2012 and 2014, respectively. Data were analyzed to find the prescribing pattern of cephalosporin and its appropriateness in relation to ASP program guidelines. Results: Three hundred case files were collected and analyzed (n=150 each from the year 2012 and 2014). The mean age of patients in both years was 6.21 years±5.63 (the year 2012) and 5.88 years±5.88 in (the year 2014). Majority of children, that is, 47.3% were suffering from infectious diseases in the year 2012 while in the year 2014, 38.7% suffered from infectious diseases. Post-implementation of ASP, there was an improvement in the appropriateness of cephalosporin prescribing in terms of prophylactic and empirical treatments. Switch over of parenteral cephalosporins to oral was observed in 54.0% patients in 2012, while in 2014, it was seen in 51.3% of patients. There was a 4.6% rise in prescriptions containing 1st generation cephalosporins. Overall there was a significant impact of ASP in terms of appropriate cephalosporin prescribing (p=0.039). Conclusion: Implementation of ASP and its adherence by pediatricians can improve antibiotic prescribing in children