A study on management of hypertension in patients with type 2 diabetes mellitus in tertiary care teaching rural hospital

Background: This study was aimed to analyze the drug utilization pattern in the management of hypertension in diabetic patients.Methods: A prospective, observational and non interventional study was conducted in 100 diabetic hypertensive patients admitted in medicine wards at Dhiraj Hospital. Patients who signed informed consent form were only included in the study. All the data were recorded from patients’ case files and analyzed.Results: Of enrolled 100 patients, 69 (69%) were male and 31 (31%) were female and maximum number of the patients (42%) were found in the age group of 51-60 years. Out of 100 admitted patients, 75% patients were treated with single antihypertensive agent, 20% were treated with combination of two antihypertensive agents while only 5% were administered more than two antihypertensive agents. As a single antihypertensive agent, most commonly prescribed was ACE inhibitors (32%), Calcium Channel Blockers (23%), Angiotensin Receptor Blockers (12%) and β1 blockers (8%).Conclusions: There was poor awareness among the patients regarding control of hypertension, regular follow up, medication adherence etc. However, two third of diabetic patients had achieved blood pressure target control and ACE inhibitor remained first choice of drug for hypertension in diabetes in this study

A study on management of type 2 diabetic patients with complications

Background: Diabetes is a major public health problem both in developing and non-developing countries across the world. It is a chronic disease, which in long term causes several complications resulting in poly pharmacy for its management. Hence, this study was determined to analyze the drug utilization pattern for the management of type 2 diabetes with complications.Methods: A prospective, observational and non-interventional study was carried out in 100 diabetic patients with one or other complications admitted in medicine wards at Dhiraj Hospital. Patients who signed informed consent form were only included in the study. All the data were recorded from patients’ case files and analyzed.Results: Result of total 100 patients, maximum number 52 (52%) were falling in group of 61-70 kg and only 2 (2%) in 81-90 kg. Out of 100 diabetic patients, 40 (40%) were managed with insulin in addition to oral antidiabetic agents, 37 (37%) were managed with only Oral Hypoglycemic Agents (OHA) and 23 (23%) were managed with only insulin. The most commonly prescribed oral antidiabetic group of drug was Biguanides in 60 (60%) and most prescribed insulin was short acting Insulin in 40 (40%) patients.Conclusions: The diabetic patients are more prone to cardiovascular and other complications leading to a co morbid condition. The poly pharmacy is likely to occur in diabetic patients suffering with secondary complications. Therefore, intense blood sugar control with proper education can prevent the co morbid state and finally helps in reducing the economic burden

A survey study on use of over the counter (OTC) drugs among medical students, nursing and clerical staff of a tertiary care teaching rural hospital

Aim: The study was conducted to evaluate use of over the counter (OTC) drugs among the medical students, nursing and clerical staff of tertiary care teaching rural hospital to determine the awareness and disadvantages on use of OTC.Methods: Responses to a feedback questionnaire covering various aspects on usage of OTC drugs were obtained from 100 medical students, 100 nursing and 100 clerical staff.Results: Among 300 respondents, 84% used OTC, commonly purchased by self. Majority of them started self medication within 2 days of their illness. The frequently reported illness that prompted self-medication included headache, cough and cold, fever, generalised weakness, acidity, dysmenorrhoea, and sleep disturbances. Majority of them obtained OTC by mentioning name of drug (81%), 35% by telling symptom and 15% by showing old prescription. We found that 87% people share OTC among relatives and friends.Conclusions: Usage of OTC was highest amongst medical students and nursing staff. Time consumption for consultation, the consultation fees and frequent visits were the commonly mentioned reasons for self medication. It was analysed that none of the clerical staff were aware of the drug, dose, frequency of administration and adverse reactions. While very little awareness of medication was found even among nursing staff and medical students. Therefore it is suggested that the public has to be educated on the type of illnesses to be self-diagnosed and medicated, dangers of OTC on misuse which would possibly lead to delay in detection of more serious underlying ailment and timely medication

A prospective survey study on premenstrual syndrome in young and middle aged women with an emphasis on its management

Premenstrual syndrome (PMS) is defined as the recurrence of psychological and physical symptoms in the luteal phase, which remit in the follicular phase of the menstrual cycle. Symptoms of which fall in three domains: emotional, physical and behavioural e.g. irritability, anger, headache, fatigue, food cravings etc. The survey study of was conducted among 50 young & 50 middle aged women of S.B.K.S Medical Institute and Research Centre to find the prevalence of premenstrual syndrome with an emphasis on its management. Responses to a feedback questionnaire covering various aspects related PMS were obtained from 50 participants belonging to each group. The participants belonged to different range of literacy. It was found that 42% faced PMS regularly, while 58% occasionally. Of the 100 participants 68% suffered with backache, 64% leg cramps, 62% fatigue, breast tenderness and anger whereas 58% suffered with anxiety and generalized body ache. Of all the sufferers only 34% had received the treatment for PMS. Irrespective of the age PMS is common problem faced by women. With our study we observed that literacy has not mattered in the management of this health problem. Since there are reports stating that the severity of PMS can hamper the daily routine and even lead to suicidal tendency, it is essential that awareness programs need to be conducted to address the importance of managing the issue by pharmacological and non-pharmacological methods

A prospective study on the use of magnesium sulfate in prevention and management of eclampsia with emphasis on adverse drug reactions

Introduction: The hypertensive disorders in pregnancy are the leading causes of maternal and perinatal mortality. Management of preeclampsia and eclampsia remains controversial even today. Several drugs with different regimens are available at present. As a consequence; women are treated in various ways by different regimens.Aim: Our work aimed to study the use of various magnesium sulfate regimens used in management of eclampsia in a tertiary care teaching rural hospital.Methods: A prospective, observational, non-interventional study was carried out among the eclamptic patients admitted to obstetrics ward. After explaining the purpose and method of study, through the patient information sheet, patients willing to sign the informed consent form were enrolled for the study. Relevant data was gathered from their case files and by direct interview with the patients that were recorded in the case record form.Results: Of the 35 cases of eclampsia recorded during the study period, we observed that all the patients were treated with Pritchard’s regimen of Magnesium Sulfate. It was noticed that there was improvement in all the patients with no adverse drug reactions recorded during the time of management.Conclusion: Maternal and perinatal mortality can be reduced to major extent by prevention of eclampsia. Prompt diagnosis and institution of therapy by selecting an ideal anticonvulsant is essential as the maternal and perinatal mortality progressively rises with increase no of convulsions. Magnesium Sulfate is a potent anticonvulsant with mild antihypertensive activity with less adverse effects.

A prospective study on drug utilization pattern & rationality in treatment of type II diabetes mellitus: a population based analysis

Background: Diabetes a chronic disease is associated with significant morbidity, complications with poor glycemic control. Hence, meticulous management is necessary. Comorbid conditions increase chances of polypharmacy and irrational prescriptions in diabetic patients. This prospective non interventional study aimed to gather and study the drug utilization pattern in diabetic patients.Methods: The study was conducted in 50 diabetic patients admitted in medicine ward. Patients were included in the study only after obtaining written informed consent form; all relevant data were collected from case record forms and were analyzed.Results:Diabetes mellitus was observed to be highest in patients with the age group of 60-70 years, affecting 66% males and 34% females. Among the participants 42 (84%) were already on treatment for diabetes while 8 (16%) were diagnosed at the time of admission. We observed that 27 (54%) patients were treated with insulin + oral hypoglycemic agents, 13 (26%) were treated with only Insulin while 10 (20%) patients were prescribed only oral hypoglycemic agents. The most common comorbid conditions observed by us were hypertension, chronic renal disease, diabetic foot, septicemia, urinary tract infections and other susceptible infections.Conclusion:To conclude, the study reveals that Metformin continues to be the choice of oral hypoglycemic agents with least adverse effects and insulin was used to treat uncontrolled state, where physicians have greatly considered the socio-economic status while prescribing which is obvious with least use of costly insulin preparations.

Small group teaching: An effective way of learning in medical education

The medical education is shifting from teacher centric methods to student centric methods in these times. Nowadays more emphasis is given on learning component as compared to teaching component. Earlier, the large group teaching was considered as the principle method to deliver the content to the large number of students. But since few years, the small group teaching has over taken in imparting the knowledge as well as skills in medical students. The small group teaching plays a key role in developing confidence, self learning ability, critical thinking as well as problem solving skills, and leadership & team working capacity among the students. In this method, the educator plays a role of facilitator rather than lecturer, where the students are given problems or tasks instead of readymade solutions. It provides opportunity to the students for interactive discussion and masters them in communication skills also which is need of the time. Small group teaching demands time, resources, well planning and active participation from both educators as well as learners. If some principles are considered and followed then it can give better outcome and can be made enjoyable reflective learning experience for students

Pharmacovigilance: Significance and challenges

The World Health Organization (WHO) defines Pharmacovigilance as the science & activities relating to detection, assessment, understanding and prevention of adverse effects or any other drug related problem. The National Pharmacovigilance Programme (NPVP) was launched in 2004 with World Bank funding till 2009, which was renamed as Pharmacovigilance Programme of India (PvPI). With advancement in the field of science and technology, India is emerging as a hub for clinical trials and new drug development, which challenges the monitoring of safety concerns in the use of new drugs. It has been difficult to identify or track the adverse drug reactions (ADRs) that occur in the patients due to polypharmacy, use of over the counter (OTC) preparations, change in physician etc. Hence the national programme has gained importance in our country off late. Yet it is observed that the importance of this programme is not realized by all health care professionals. Therefore, to support & strengthen the national programme which aims to identify, report & analyze the identified ADRs, it would be essential to sensitize the health care professionals through various means & faculty development programmes

Pharmacovigilance: Significance and challenges

The World Health Organization (WHO) defines Pharmacovigilance as the science & activities relating to detection, assessment, understanding and prevention of adverse effects or any other drug related problem. The National Pharmacovigilance Programme (NPVP) was launched in 2004 with World Bank funding till 2009, which was renamed as Pharmacovigilance Programme of India (PvPI). With advancement in the field of science and technology, India is emerging as a hub for clinical trials and new drug development, which challenges the monitoring of safety concerns in the use of new drugs. It has been difficult to identify or track the adverse drug reactions (ADRs) that occur in the patients due to polypharmacy, use of over the counter (OTC) preparations, change in physician etc. Hence the national programme has gained importance in our country off late. Yet it is observed that the importance of this programme is not realized by all health care professionals. Therefore, to support & strengthen the national programme which aims to identify, report & analyze the identified ADRs, it would be essential to sensitize the health care professionals through various means & faculty development programmes

Post COVID complications: Need to be vigilant in post epidemic era

COVID-19 has occurred worldwide and left the detrimental effects affecting millions of people & caused deaths. It has affected almost every system of the body and left the survivors suffering with one or other complications. This review has studied and analyzed many articles published during and post COVDI period. The post COVID symptom varies from psychological to multiorgan involvement. This review was undertaken with the purpose of presenting a current scenario regarding the long term complications among the survivors from the various literatures. This may help the health care providers to be vigilant for observing and monitoring these symptoms in patients who suffered with COVID-19, which may help to provide better health care and improve their quality of life